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Overview of COVID-19-Related Neurological Complications in Children

Overview of COVID-19-Related Neurological Complications in Children

 


*Important Notices: research plaza We publish a non-peer-reviewed, preliminary scientific report and should not be taken as conclusive, to guide clinical practice/health-related actions, or to be treated as established information.

In a recent study posted on Research Square* An international team of researchers, the preprint server, has examined the current literature to identify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, abnormal neuroimaging symptoms, and neurological findings in individuals under the age of 18 years. I understand the connection with physical symptoms.

Study: Association of SARS-CoV-2 infection with neurological and neuroimaging symptoms in a pediatric population: a systematic review. Image credit: alekso94 / Shutterstock.com

study: Association of SARS-CoV-2 infection with neurological and neuroimaging symptoms in the pediatric population: a systematic review. Image credit: alekso94 / Shutterstock.com

Background

The clinical picture of coronavirus disease 2019 (COVID-19) varies greatly among individuals, ranging from asymptomatic or mild to severe disease with acute respiratory distress syndrome (ARDS), pneumonia, and multisystem complications.

Emerging evidence suggests a thrombogenic response and cytokine storm Those with acute onset of COVID-19 have a high incidence of intracerebral hemorrhage and ischemic stroke, which contribute to psychiatric and neurological complications.

While many studies have investigated neurological complications associated with acute SARS-CoV-2 infection in adults, COVID-19 symptoms in children are mostly asymptomatic or mild and do not require hospitalization.

However, emerging evidence points to systemic manifestations such as secondary inflammatory reactions. Multisystem inflammatory syndrome in children (MIS-C), has been observed among children with acute COVID-19. MIS-C is rare but associated with a high incidence of neuroimaging abnormalities and neurological complications. Nevertheless, the extent of central nervous system (CNS) complications associated with SARS-CoV-2 infection in children remains unknown.

About research

In this study, investigators conducted a peer-reviewed study of COVID-19-related neurological symptoms and abnormal symptoms during neuroimaging in individuals under the age of 18 with laboratory-confirmed SARS-CoV-2 infection. review the literature. The studies reviewed included case-control studies, case reports, pilot studies, observational studies, cohort studies, clinical trials, randomized controlled trials, and other types of study designs.

Results of the studies reviewed included neuroimaging by computed tomography (CT), positron emission tomography (PET), magnetic resonance imaging (MRI) scans, or other modalities.

Were studies involving individuals with unconfirmed SARS-CoV-2 infection or previous neurological comorbidities performed in animal models only or did not include definitive reporting of neurological scan findings? , cognitive assessments were excluded, as were dissertations, abstracts and reviews. , perspective papers, guidelines, editorials.

Data from these studies vary in severity of COVID-19, number of SARS-CoV-2-positive children with abnormal neurological symptoms or neuroimaging scans, and type and timing of its onset. analyzed according to standard. neurological complications.

result

The pediatric population generally experienced mild SARS-CoV-2 infection, but 19 studies found that 12.8% of children who experienced severe COVID-19 requiring hospitalization had neurocognitive impairment. reporting.

Of the patients presenting with neurological abnormalities, 24.2% had MIS-C and 10.1% had neurological disorders such as acute disseminated encephalomyelitis, myelitis, encephalitis, meningitis, meningitis, or meningoencephalitis. They presented with inflammatory symptoms and 8.1% had encephalopathy.

Symptoms such as muscle weakness and drowsiness were more common in childhood than in adolescence. Children also showed more irritability and agitation than infants.

SARS-CoV-2’s neurotropic ability, in which the virus uses angiotensin-converting enzyme 2 (ACE-2) receptors to enter neurons, is hypothesized to cause COVID-19 to cause neurological complications. It’s one of the mechanisms. Pediatric population.

Neurotropism is thought to disrupt intracellular neuronal homeostasis and the blood-brain barrier, ultimately leading to inflammation. Inflammatory symptoms may also explain the predominant symptoms of seizures and headaches commonly reported in many studies.

SARS-CoV-2 entry via the olfactory tract or ACE-2 receptors may also disrupt the blood-brain barrier, thereby exposing the immune system to antigens from the CNS.

The researchers also discussed similarities between COVID-19 and demyelinating-related disorders such as Guillain-Barré syndrome. Due to neuronal molecular mimicry of COVID-19 antigenic factors, the interaction of SARS-CoV-2 with myelin autoantigens could ultimately lead to neuronal damage.

A study investigating persistent complaints of dysfunction in adolescent COVID-19 patients reported PET scans showing a pattern of hypermetabolism in the medial temporal lobe and olfactory gyrus that extended to the cerebellum and pons. Similar results were observed in her long-term adult COVID patients.

Conclusion

Although COVID-19 symptoms were mostly mild in children and adolescents, a significant proportion of pediatric COVID-19 patients experienced MIS-C. In addition, encephalopathy and neuroinflammatory symptoms were moderately common among these patients.

More longitudinal studies are urgently needed to understand the age-related heterogeneity of COVID-19-related neurological complications in the pediatric population.

*Important Notices: research plaza We publish a non-peer-reviewed, preliminary scientific report and should not be taken as conclusive, to guide clinical practice/health-related actions, or to be treated as established information.

Sources

1/ https://Google.com/

2/ https://www.news-medical.net/news/20230314/An-overview-of-COVID-19-associated-neurological-complications-in-children.aspx

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