Acute Neurological Presentation in Children With SARS-CoV-2 Infection

In the pediatric population, the knowledge of the acute presentation of SARS-CoV-2 infection is mainly limited to small series and case reports, particularly when dealing with neurological symptoms. We describe a large cohort of children with acute SARS-CoV-2 infection, focusing on the neurological...

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Bibliographic Details
Published in:Frontiers in pediatrics 2022-07, Vol.10, p.909849
Main Authors: Riva, Antonella, Piccolo, Gianluca, Balletti, Federica, Binelli, Maria, Brolatti, Noemi, Verrotti, Alberto, Amadori, Elisabetta, Spalice, Alberto, Giacomini, Thea, Mancardi, Maria Margherita, Iannetti, Paola, Vari, Maria Stella, Piccotti, Emanuela, Striano, Pasquale, Brisca, Giacomo
Format: Article
Language:English
Subjects:
acute
children
COVID-19
neurological symptoms
Pediatrics
SARS-CoV-2
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Summary:In the pediatric population, the knowledge of the acute presentation of SARS-CoV-2 infection is mainly limited to small series and case reports, particularly when dealing with neurological symptoms. We describe a large cohort of children with acute SARS-CoV-2 infection, focusing on the neurological manifestations and investigating correlations between disease severity and population demographics. Patients aged 0-18 years with a positive molecular swab were recruited between April 2020 and March 2021 from a tertiary Italian pediatric centre. Clinical data, imaging, and laboratory test results were retrieved from our local dataset and statistically analyzed. A total of 237 patients with a median age of 3.2 years were eligible; thirty-two (13.5%) presented neurological symptoms, including headache (65.6%), altered awareness (18.8%), ageusia/anosmia (12.5%), seizures (6.3%), and vertigo (6.3%), combined in 7 (21.9%) cases. Respiratory (59.5%) and gastrointestinal (25.3%) symptoms were the most common among the 205 (86.5%) patients neurological involvement. Neurological symptoms did not significantly influence the severity of the triage access codes. Moreover, pre-existing medical conditions were not higher in the group neurological manifestations. Overall, fifty-nine patients (25%, 14/59 neurological symptoms) required treatment, being antibiotics, systemic steroids, and heparin those most prescribed. Our study supports the overall benign course of the SARS-CoV-2 infection in children. Neurological manifestations, except for headache, remain a rare presenting symptom, and disease severity seems unrelated to pre-existing medical conditions.
ISSN:2296-2360
2296-2360
DOI:10.3389/fped.2022.909849