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Published on: August 10, 2018
COVID-19 Infection in Spinal Muscular Atrophy Associated with Multisystem Inflammatory Syndrome
Rafat Mosalli1,2, Amirah Al Matrafi3, Mohammed A Ghazi2,4
1Department of Pediatrics, Umm Al-Qura University, Mecca, Saudi Arabia.
Insights
Children with spinal muscular atrophy are at higher risk for severe COVID-19 and multisystem inflammatory syndrome. Early diagnosis and protective measures are crucial for managing coronavirus disease-2019 in pediatric neurological patients.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Critical Care Medicine
Background:
- Coronavirus disease-2019 (COVID-19) typically presents with milder symptoms in children compared to adults.
- Children with underlying neurological conditions, such as spinal muscular atrophy (SMA), face increased risks of severe COVID-19 and complications.
- Generalized hypotonia and respiratory failure are characteristic manifestations of SMA in pediatric patients.
Observation:
- A 3-year-old female with SMA and respiratory failure tested positive for COVID-19.
- The patient subsequently developed multisystem inflammatory syndrome (MIS-C).
- Treatment involved intravenous immunoglobulin and tocilizumab.
Findings:
- Despite treatment, the patient with SMA, COVID-19, and MIS-C experienced a fatal outcome.
- This case underscores the vulnerability of children with neurological disorders to severe COVID-19.
- Multisystem inflammatory syndrome represents a significant, potentially lethal, complication in this population.
Implications:
- Highlights the critical need for vigilant monitoring of pediatric patients with neurological impairments during the COVID-19 pandemic.
- Emphasizes the importance of implementing stringent protective measures in healthcare settings for immunocompromised children.
- Stresses the necessity of early COVID-19 testing and prompt diagnosis in children with pre-existing neurological conditions to improve outcomes.
Abstract:
The coronavirus disease-2019 (COVID-19) is usually less severe and less prevalent in the pediatric population. Children with preexisting conditions such as neuromuscular impairments and chronic lung disease are more susceptible to COVID-19 and may incur several complications with a poor outcome. We present a case report of a 3-year-old-female with generalized hypotonia and respiratory failure due to spinal muscular atrophy who tested positive for COVID-19 and developed multisystem inflammatory syndrome that was treated with intravenous immunoglobulin and tocilizumab and subsequently died. The report highlights the importance of close surveillance, the use of protective measures during hospital visits, early testing, and diagnosis of COVID-19 in children with neurological disorders.
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