Meningoencephalitis and postinflammatory hydrocephalus in the course of COVID-19 disease in newborn – the potential role of acetazolamide as add-on therapy to the standard treatment

Abstract

Wątroba SJ, Bryda J. Meningoencephalitis and postinflammatory hydrocephalus in the course of COVID-19 disease in newborn -the potential role of acetazolamide as add-on therapy to the standard treatment. Ann Agric Environ Med.

COVID-19 among infants: key clinical features and remaining controversies

“…10) Seizures of variable types are common among the more con crete neurological events. 9,24,28,30,49,[88][89][90][91][92][93][94][95][96][97] As expected, some are particularly detailed as febrile seizures. 24) In a large American multi center surveillance study, neonatal COVID-19 was accom panied by a 1.9% frequency of seizures; the frequency did not differ significantly between severe and non-severe patient groups.…”

“…It is also not apparent if the collations and their proportionalities are influenced by selection bias, but the proportion of infants meeting soft or hard criteria for neurological presentations reached 12% in larger reviews [ 10 ]. Seizures of variable types are common among the more concrete neurological events [ 9 , 24 , 28 , 30 , 49 , 88 - 97 ]. As expected, some are particularly detailed as febrile seizures [ 24 ].…”

“…The latter, however, contrasts with another large review in which the outcome of the neurological presentation was more common among infants with severe COVID-19 [ 10 ]. Other infants reportedly had encephalopathy or meningitis or meningoencephalit is [ 9 , 49 , 88 , 92 , 93 ]. Intraventricular hemorrhage has arisen during the course of infection [ 9 ].…”

If SARS-CoV-2 is blamed for causing meningoencephalitis, the virus must be detected in the CSF

“…We have read with interest the article by Watroba and Bryda on a new-born male with SARS-CoV-2 associated meningo-encephalitis, post-inflammatory hydrocephalus and seizures [1]. Neuro-COVID in this patient was treated with a polypragmatic approach, including phenobarbital, acetazolamide, fluconazole, acyclovir, cefotaxime, and vancomycin [1]. The study is appealing but has limitations that raise concerns and should be discussed.…”

“…A limitation of the study is that the infectious nature of meningo-encephalitis was not confirmed as the RT-PCR for SARS-CoV-2 was negative in the cerebrospinal fluid (CSF) [1]. We would like to know why the patient was diagnosed with meningo-encephalitis due to SARS-CoV-2 without evidence of a causative agent in the CSF.…”