Unusual neurological manifestations in children during the COVID-19 pandemic
Developmental Medicine and Child Neurology
; 64(SUPPL 1):24, 2022.
Artigo
em Inglês
| EMBASE | ID: covidwho-1723130
ABSTRACT
Objective:
To present paediatric cases of unusual neuroinflammatory conditions encountered during the COVID-19 pandemic in Trinidad & Tobago.Methods:
Retrospective study design. Inpatient paediatric patients (aged 0-16 years) hospitalized for neurological complaints from June 2020 - August 2021 at EWMSC. Outcome measures were age at presentation, sex, ethnicity, diagnosis, radiological findings, blood/CSF findings, COVID-19 PCR and antibodies testing, treatment, outcomes and other systems involved.Results:
Twenty (20) patients (aged 4-months-old to 15-years-old) had documented neurological involvement. 50% had a diagnosis of ADEM/ADS/AHNE;45% had a diagnosis of either CNS vasculitis (n=3), autoimmune encephalitis (n=3) or GBS (n=3);5% had a diagnosis of acute COVID-19 encephalitis. 70% were of African descent. The youngest age group (0-4 years) (n=11) constituted more males (82%) whereas the eldest age group (10-15 years) (n=3) were all females. Neuroimaging findings were corpus callosal lesions;deep white matter T2 hyperintensities;cerebellar involvement;area postrema and brainstem/C-spine involvement;microhaemorrhages and necrotizing/haemorrhagic lesions (peripheral/central). 70% of patients were either SARS-CoV-2 PCR or COVID-19 antibodies positive. Other systems were involved in 40% to 62.5% (n=5) had cardiac involvement (myocarditis, coronary arteries dilatation, valve regurgitation) and 37.5% (n=3) had pancreatic involvement (autoimmune pancreatitis, type 1 diabetes mellitus). Treatment modalities for CNS manifestations (n=17) were clinically based - 24% (n=4) 3rd line treatment, 29% (n=5) 2nd line treatment, 41% (n=7) 1st line treatment and 6% (n=1) requiring no treatment. All 3 patients with a diagnosis of GBS responded appropriately to IVIG. Developmental outcomes were worst in patients with a diagnosis of autoimmune encephalitis.Conclusion:
We have had an explosion of neuro-inflammatory cases since the COVID-19 pandemic began. The range of neuroradiological diagnoses and other systemic involvement (including criteria for PIMS) are interesting, alluding to a neuroinflammatory mechanism. Effects on long-term sequelae and developmental outcomes are concerning in some cases, however, still unknown at this stage.
human immunoglobulin; acute disseminated encephalomyelitis; adolescent; area postrema; autoimmune encephalitis; autoimmune pancreatitis; brain stem; central nervous system; central nervous system vasculitis; cerebellum; cerebrospinal fluid; cervical spine; child; clinical article; complication; conference abstract; controlled study; coronary artery; coronavirus disease 2019; diagnosis; dilatation; drug therapy; encephalitis; ethnicity; explosion; female; groups by age; hospital patient; human; insulin dependent diabetes mellitus; male; myocarditis; neuroimaging; neurologic disease; nonhuman; outcome assessment; pandemic; pediatric patient; preschool child; retrospective study; Severe acute respiratory syndrome coronavirus 2; valve; white matter
Texto completo:
Disponível
Coleções:
Bases de dados de organismos internacionais
Base de dados:
EMBASE
Idioma:
Inglês
Revista:
Developmental Medicine and Child Neurology
Ano de publicação:
2022
Tipo de documento:
Artigo
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