Cerebral Venous Sinus Thrombosis in a Pediatric Patient With COVID-19

Bastidas, Hyaissa Ippolito; Márquez-Pérez, Trinidad; García-Salido, Alberto; Luglietto, Davide; Moreno, Rafael García; Azagra-Garde, Amelia Martínez de; Nieto-Moro, Montserrat; Leoz-Gordillo, Inés; Budke, Marcelo; Rivero-Martín, Belén

doi:10.1212/cpj.0000000000000899

Cited by 18 publications

(15 citation statements)

References 8 publications

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“… 33 Another salient aspect was that 8 of the 12 patients developed radiological features compatible with pneumonia, despite respiratory symptoms not being the chief complaint at admission. 34 Given the clinical manifestations, the results of diagnostic tests and the clustering of cases in a time period that did not coincide with the incidence peaks, we hypothesised that infection by SARS-CoV-2 could trigger an inflammatory response leading to shock. Seven of these patients had a positive result of the RT-PCR tests for SARS-CoV-2, but only 5 had a positive IgG antibody test result, suggesting that this inflammatory response can develop during or after the acute phase.…”

Section: Discussionmentioning

confidence: 99%

Clinical spectrum and risk factors for complicated disease course in children admitted with SARS-CoV-2 infection

Storch-de-Gracia

Leoz-Gordillo

Andina

et al. 2020

Anales de Pediatría (English Edition)

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Introduction At this time there are still major questions about the characteristics of disease caused by the new coronavirus (COVID-19) in children as well as factors associated with the development of severe forms of the disease. Study design Retrospective study including patients under 18 years of age admitted with SARS-CoV-2 infection from March 1 to April 30, 2020. Infection was confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) or antibody testing. We describe the epidemiological and clinical data, laboratory and imaging findings, as well as treatment and outcome in these patients. In light of these findings, patients were classified into two severity groups and then compared. Results Thirty-nine children were included, with a median age of 9 years (range 12 days–16 years); 23 were boys. Cases with uncomplicated disease course (24) mostly presented to the emergency department (ED) with fever and/or respiratory symptoms without significant alterations in laboratory findings. Of the 15 children with a complicated course, 12 developed shock. In addition to fever, they frequently presented altered appearance, extreme tachycardia, abdominal pain, vomiting, diarrhea, rash, and/or conjunctival hyperemia. They also showed greater lymphopenia ( p = 0.001), elevated neutrophil/lymphocyte ratio ( p = 0.001), C-reactive protein ( p < 0.001), procalcitonin ( p = 0.001), D-dimer ( p < 0.001), and ferritin ( p < 0.001). Conclusions SARS-CoV-2 infection in admitted children presents with great clinical variability. When provided supportive care, patients with predominant respiratory symptoms without altered laboratory-test results generally have an uncomplicated course. Patients with complicated disease present mainly with fever and abdominal and/or mucocutaneous symptoms. Most develop shock. Elevation of inflammatory markers may allow for early detection and the final outcome is good.

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Section: Discussionmentioning

confidence: 99%

Clinical spectrum and risk factors for complicated disease course in children admitted with SARS-CoV-2 infection

Storch-de-Gracia

Leoz-Gordillo

Andina

et al. 2020

Anales de Pediatría (English Edition)

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“…There were seven case series [10,[13][14][15][16][48][49][50], 23 case reports [18][19][20][21][22][23][24][25][28][29][30][31][32][34][35][36][37][38][40][41][42][43]52], and the rest were letters to the editor, brief reports, and a scientific letter. Two studies were international [15,16], twenty studies were from the USA [13,[17][18][19][20]24,[28][29][30]32,33,35,[37][38][39]41,47,48,…”

Section: Study Characteristicsmentioning

confidence: 99%

“…From the 159 patients, 38 were reported with some type of cerebrovascular disease [12][13][14][15][16][17][18][19][20][21][22], 32 with different types of encephalitis [13][14][15][26][27][28][29][30][31][32], 22 with encephalopathy [10,13,24,25], and 10 patients with Guillain-Barre syndrome [13,14,[42][43][44]. Sixty-five out of 159 patients with severe neurological manifestations, were reported with Multisystem Inflammatory Syndrome (MIS-C) [10,12,[14][15][16][17]23,32,45,50,[52][53][54] (Table 1).…”

Section: Patient Backgroundmentioning

confidence: 99%

A Systematic Review of Severe Neurological Manifestations in Pediatric Patients with Coexisting SARS-CoV-2 Infection

O'Loughlin

Toledo

Budrie

et al. 2021

Neurology International

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SARS-CoV-2 infection in children produces mild respiratory symptoms or no symptoms at all in most cases. Some pediatric patients develop a severe complication associated with high mortality, the multisystem inflammatory syndrome in children (MIS-C). In both scenarios, there are reports of neurological manifestations. This article aims to review the cases of pediatric patients with severe neurological issues and a coexisting positive SARS-CoV-2 test. A literature search was performed between March 2020 and May 2021. The results included the data from 41 studies, with 159 children with severe neurological manifestations, within an age range from 24 h to 17 years. The neurological disorders included 38 cases with stroke, 32 with encephalitis, 22 with encephalopathy, and 10 with Guillain–Barre syndrome. Sixty-five out of 159 cases with severe neurological manifestations were diagnosed with MIS-C. Direct neuroinvasion and the exaggerated immune response in some patients seem to be the most critical factors triggering these manifestations. Further research in the ongoing pandemic is needed to elucidate the precise mechanism.

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“…La LDH no parece ser un marcador analítico de gravedad en nuestros pacientes, lo que contrasta con los adultos 33 . También es importante señalar que ocho de los 12 pacientes desarrollaron neumonía radiológica aunque los síntomas respiratorios no eran predominantes en el momento del ingreso 34 . Debido a los hallazgos clínicos y de laboratorio y a la agrupación de casos en un período fuera de los niveles máximos de la epidemia, formulamos la hipótesis de que la infección por SARS-CoV-2 puede desencadenar una respuesta inflamatoria que lleve al shock .…”

Section: Discussionunclassified

Espectro clínico y factores de riesgo de enfermedad complicada en niños ingresados con infección por SARS-CoV-2

Storch-de-Gracia¹,

Leoz-Gordillo²,

Andina³

et al. 2020

Anales de Pediatría

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Introducción En este momento existen todavía grandes interrogantes acerca de las características de enfermedad causada por el nuevo coronavirus (COVID-19) en los niños, así como acerca de los factores asociados al desarrollo de formas graves de la enfermedad. Métodos Estudio retrospectivo que incluye pacientes menores de 18 años ingresados debido a infección por SARS-CoV-2. La infección fue confirmada por la reacción en cadena de la transcriptasa inversa-polimerasa (RT-PCR) en tiempo real o por serología. Describimos los datos epidemiológicos y clínicos, los hallazgos de laboratorio y de imágenes, así como el tratamiento y la evolución de estos pacientes. Los pacientes se clasificaron en dos grupos de gravedad y luego se compararon. Resultados Se incluyeron 39 niños, con una mediana de edad de nueve años (rango 12 días-16 años); 23 eran varones. Los casos con evolución no complicada (24) se presentaron en su mayoría con fiebre y/o síntomas respiratorios sin alteraciones significativas en los hallazgos de laboratorio. De los 15 niños con enfermedad complicada, 12 desarrollaron shock . Además de la fiebre, frecuentemente presentaban alteraciones de la apariencia, taquicardia extrema, dolor abdominal, vómitos, diarrea, erupción cutánea y/o hiperemia conjuntival. También mostraron mayor linfopenia (p = 0,001), elevación de la proporción neutrófilos/linfocitos (p = 0,001), proteína C reactiva (p < 0,001), procalcitonina (p = 0,001), dímero D (p < 0,001) y ferritina (p < 0,001). Conclusiones La infección por SARS-CoV-2 en niños ingresados se presenta con una gran variabilidad clínica. Cuando se les proporciona tratamiento de soporte, los pacientes con síntomas respiratorios que no tienen alteración de las pruebas de laboratorio, generalmente tienen una enfermedad no complicada. Los pacientes con enfermedad complicada se presentan principalmente con fiebre y síntomas abdominales y/o mucocutáneos, la mayoría desarrollan un shock . La elevación de los marcadores inflamatorios puede permitir una detección temprana y el pronóstico final es bueno.

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Cerebral Venous Sinus Thrombosis in a Pediatric Patient With COVID-19

Cited by 18 publications

References 8 publications

Clinical spectrum and risk factors for complicated disease course in children admitted with SARS-CoV-2 infection

Clinical spectrum and risk factors for complicated disease course in children admitted with SARS-CoV-2 infection

A Systematic Review of Severe Neurological Manifestations in Pediatric Patients with Coexisting SARS-CoV-2 Infection

Espectro clínico y factores de riesgo de enfermedad complicada en niños ingresados con infección por SARS-CoV-2

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