COVID-19: Neurological Considerations in Neonates and Children

Stafstrom, Carl E.; Jantzie, Lauren L.

doi:10.3390/children7090133

Cited by 73 publications

(97 citation statements)

References 112 publications

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“…1 Many neurological manifestations of COVID-19 have been reported in the literature that range from mild non-specific features such as headache, lethargy or confusion; isolated focal signs including hyposmia, focal seizures, eye-movement abnormalities or ataxia; through to severe life-threatening conditions including status epilepticus, Guillain Barre syndrome, disseminated stroke syndromes and acute haemorrhagic necrotizing encephalopathy. 2,3 In addition to these, a newly recognized Kawasaki syndrome-like hyperinflammatory disorder has been recognized in children called as MIS-C. This presents with fever, laboratory evidence of inflammation and multisystem (> = 2 organ) involvement, manifesting up to 3-4 weeks following a mild or asymptomatic COVID-19 illness.…”

Section: Discussionmentioning

confidence: 99%

Acute Post‐Infectious Cerebellar Ataxia Due to COVID‐19

Tomar

Shah

Agarwal

et al. 2021

Movement Disord Clin Pract

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Section: Discussionmentioning

confidence: 99%

Acute Post‐Infectious Cerebellar Ataxia Due to COVID‐19

Tomar

Shah

Agarwal

et al. 2021

Movement Disord Clin Pract

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“…Children are considered less susceptible to SARS-CoV-2 compared with adults [ 131 ] and generally present with milder COVID-19 symptoms [ 132 ]. While neurological manifestations are relatively rare among children, gustatory dysfunction has been increasingly reported in younger cohorts [ 133 ]. Fontanet et al [ 134 ] conducted a retrospective cohort study of primary school pupils aged six to 11 years in northern France and found that ageusia is present in only 1% of them.…”

Section: Gustatory Dysfunctionmentioning

confidence: 99%

Oral Symptoms Associated with COVID-19 and Their Pathogenic Mechanisms: A Literature Review

Tsuchiya

2021

Dentistry Journal

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Since the worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, management of coronavirus disease 2019 (COVID-19) has been challenging for healthcare providers. The oral cavity is referred to as a target of SARS-CoV-2. The aim of this study was to review oral symptoms specific to COVID-19 patients from the point of view of symptom prevalence and pathogenesis and to speculate the pathogenic mechanisms underlying them. Scientific articles were retrieved by searching PubMed/MEDLINE, Google Scholar, medRxiv, and bioRxiv from 3 February 2020 to 31 December 2020, and they were reviewed by title, abstract, and text for relevance. The literature search indicated that COVID-19 patients frequently present with gustatory dysfunction, xerostomia, and oral mucosal lesions, while their prevalence is likely to vary by country, age, gender, and disease severity. Gustatory dysfunction and xerostomia appear at an early stage of SARS-CoV-2 infection and last relatively long. One of possible pathogenic mechanisms of both symptoms is attributed to the expression of viral cellular entry-relevant receptors in taste cells and salivary glands. Dental professionals who can first become aware of oral symptoms associated with COVID-19 will play a more active role in and make a greater contribution to diagnosis and prevention of COVID-19.

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“…oronaviruses primarily cause respiratory disease; however, severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus, and newly identified SARS-CoV-2 have been associated with a range of disorders of the peripheral and central nervous system (CNS). [1][2][3][4][5][6][7][8][9] Early reports from Wuhan, China, described a spectrum of neurologic conditions associated with SARS-CoV-2 infection in 36% of 214 adults hospitalized with coronavirus disease 2019 (COVID-19). 10 Reported neurologic and psychiatric symptoms in adult patients with COVID-19 include anosmia/ageusia, 11,12 headaches, 13 dizziness/ataxia, 10 psychosis, dementia, depression, anxiety, and mania.…”

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confidence: 99%

Neurologic Involvement in Children and Adolescents Hospitalized in the United States for COVID-19 or Multisystem Inflammatory Syndrome

et al. 2021

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IMPORTANCE Coronavirus disease 2019 (COVID-19) affects the nervous system in adult patients. The spectrum of neurologic involvement in children and adolescents is unclear. OBJECTIVE To understand the range and severity of neurologic involvement among children and adolescents associated with COVID-19. SETTING, DESIGN, AND PARTICIPANTS Case series of patients (age <21 years) hospitalized between March 15, 2020, and December 15, 2020, with positive severe acute respiratory syndrome coronavirus 2 test result (reverse transcriptase-polymerase chain reaction and/or antibody) at 61 US hospitals in the Overcoming COVID-19 public health registry, including 616 (36%) meeting criteria for multisystem inflammatory syndrome in children. Patients with neurologic involvement had acute neurologic signs, symptoms, or diseases on presentation or during hospitalization. Life-threatening involvement was adjudicated by experts based on clinical and/or neuroradiologic features. EXPOSURES Severe acute respiratory syndrome coronavirus 2. MAIN OUTCOMES AND MEASURES Type and severity of neurologic involvement, laboratory and imaging data, and outcomes (death or survival with new neurologic deficits) at hospital discharge. RESULTS Of 1695 patients (909 [54%] male; median [interquartile range] age, 9.1 [2.4-15.3] years), 365 (22%) from 52 sites had documented neurologic involvement. Patients with neurologic involvement were more likely to have underlying neurologic disorders (81 of 365 [22%]) compared with those without (113 of 1330 [8%]), but a similar number were previously healthy (195 [53%] vs 723 [54%]) and met criteria for multisystem inflammatory syndrome in children (126 [35%] vs 490 [37%]). Among those with neurologic involvement, 322 (88%) had transient symptoms and survived, and 43 (12%) developed life-threatening conditions clinically adjudicated to be associated with COVID-19, including severe encephalopathy (n = 15; 5 with splenial lesions), stroke (n = 12), central nervous system infection/demyelination (n = 8), Guillain-Barré syndrome/variants (n = 4), and acute fulminant cerebral edema (n = 4). Compared with those without life-threatening conditions (n = 322), those with life-threatening neurologic conditions had higher neutrophil-tolymphocyte ratios (median, 12.2 vs 4.4) and higher reported frequency of D-dimer greater than 3 μg/mL fibrinogen equivalent units (21 [49%] vs 72 [22%]). Of 43 patients who developed COVID-19-related life-threatening neurologic involvement, 17 survivors (40%) had new neurologic deficits at hospital discharge, and 11 patients (26%) died. CONCLUSIONS AND RELEVANCE In this study, many children and adolescents hospitalized for COVID-19 or multisystem inflammatory syndrome in children had neurologic involvement, mostly transient symptoms. A range of life-threatening and fatal neurologic conditions associated with COVID-19 infrequently occurred. Effects on long-term neurodevelopmental outcomes are unknown.

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COVID-19: Neurological Considerations in Neonates and Children

Cited by 73 publications

References 112 publications

Acute Post‐Infectious Cerebellar Ataxia Due to COVID‐19

Acute Post‐Infectious Cerebellar Ataxia Due to COVID‐19

Oral Symptoms Associated with COVID-19 and Their Pathogenic Mechanisms: A Literature Review

Neurologic Involvement in Children and Adolescents Hospitalized in the United States for COVID-19 or Multisystem Inflammatory Syndrome

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