Association of SARS-CoV-2 Infection with Neurological Symptoms and Neuroimaging Manifestations in the Pediatric Population: A Systematic Review

Abstract

Background Neurological manifestations have been widely reported in adults with COVID-19, yet the extent of involvement among the pediatric population is currently poorly characterized. The objective of our systematic review is to evaluate the association of SARS-CoV-2 infection with neurological symptoms and neuroimaging manifestations in the pediatric population. Methods A literature search of Cochrane Library; EBSCO CINAHL; Global Index Medicus; OVID AMED, Embase, Medline, PsychINFO; and Scopus was conducted in accordance with the Peer Review of Electronic Search Strategies form (October 1, 2019 to March 15, 2022). Studies were included if they reported (1) COVID-19-associated neurological symptoms and neuroimaging manifestations in individuals aged < 18 years with a confirmed, first SARS-CoV-2 infection and were (2) peer-reviewed. Full-text reviews of 222 retrieved articles were performed, along with subsequent reference searches. Results A total of 843 nonduplicate records were retrieved. Of the 19 identified studies, there were ten retrospective observational studies, seven case series, one case report, and one prospective cohort study. A total of 6,985 individuals were included, where 12.8% of hospitalized patients experienced neurocognitive impairments: MIS-C (24.2%), neuroinflammation (10.1%), and encephalopathy (8.1%) were the most common disorders; headaches (16.8%) and seizures (3.8%) were the most common symptoms. Based on pediatric-specific cohorts, children experienced more drowsiness (7.3% vs. 1.3%) and muscle weakness (7.3% vs. 6.3%) as opposed to adolescents. Agitation or irritability was observed more in children (7.3%) than infants (1.3%). Conclusion Our findings revealed a high prevalence of immune-mediated patterns of disease among COVID-19 positive pediatric patients with neurocognitive abnormalities.

Anxiety and Depression in Pediatric-Onset Traumatic Spinal Cord Injury: A Systematic Review

“…Reduced functional independence was associated with anxiety and depression in studies reviewed. These ndings are consistent with studies on patients with other conditions, such as stroke [44], dementia [45], epilepsy [46], infectious diseases [47], traumatic brain injury [48], neurodegeneration [49], tumor [50][51][52], as well as the general healthy aging population [53][54][55], where higher stress, anxiety and depression were shown to be associated with lower functional independence and poorer outcomes. Indeed, a shorter duration of injury was associated with higher anxiety and depression.…”

Impact of Baseline Anxiety on Well-being in People with Post-COVID-19 Condition: A Secondary Analysis

“…[11][12][13] Interestingly, reduced motivation has also been identified as an important correlate with neuropsychiatric symptom severity, suggesting a complex interplay between mental health and diminished well-being in PCC. 11,14,15 Well-being is a comprehensive domain that encompasses both the physical and neuropsychiatric outcomes associated with PCC. The aftermath of the COVID-19 pandemic has been correlated with a marked decrease in overall well-being, attributable to many factors that increase the risk of anxiety and depression including COVID-19 infection, financial stress, and social isolation 16,17 Furthermore, a recent survey conducted in Switzerland revealed that individuals suffering from PCC experience a significant decline in well-being, as measured by the WHO Well-Being Index, 5-Item (WHO-5).…”

“…Other contributing factors include gender, post-COVID-19 functional impairment, general fatigue, existing comorbidities, and a prior history of mental health issues 11 – 13 . Interestingly, reduced motivation has also been identified as an important correlate with neuropsychiatric symptom severity, suggesting a complex interplay between mental health and diminished well-being in PCC 11 , 14 , 15 …”