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Spectrum of neuroimaging mimics in children with COVID-19 infection
Alex Mun-Ching Wong1, Cheng Hong Toh2
1Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Insights
Children with COVID-19 can develop serious neurological complications beyond mild respiratory symptoms. This review highlights key neuroimaging findings in pediatric neurological diseases associated with SARS-CoV-2 infection.
Area of Science:
- Neurology
- Pediatrics
- Infectious Diseases
Background:
- Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, impacts millions globally, with a notable percentage of pediatric cases.
- While often mild, COVID-19 in children can lead to severe neurological complications, sometimes linked to multisystem inflammatory syndrome.
Purpose of the Study:
- To review the characteristic magnetic resonance neuroimaging features of neurological diseases observed in children with COVID-19.
- To differentiate these conditions from other imaging mimics and discuss potential pathophysiology.
- To raise awareness among healthcare providers regarding pediatric neurological complications of COVID-19.
Main Methods:
- Literature review of pediatric neurological conditions associated with COVID-19.
- Analysis of characteristic magnetic resonance neuroimaging findings.
- Discussion of underlying pathophysiology and differential diagnoses.
Main Results:
- A spectrum of neurological diseases, including encephalitis, acute necrotizing encephalopathy, and Guillain-Barré syndrome, have been observed in children with COVID-19.
- Distinct neuroimaging patterns are associated with these pediatric neurological complications.
- Understanding these patterns aids in differentiating COVID-19-related neurological issues from other conditions.
Conclusions:
- Pediatric neurological complications associated with COVID-19 are diverse and present with specific neuroimaging characteristics.
- Awareness of these neuroimaging patterns is crucial for timely diagnosis and management in children during the pandemic.
- Continued vigilance is necessary as new SARS-CoV-2 variants emerge and the virus spreads globally.
Abstract:
Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has affected over 200 million people globally (including over 30 million people in the United States), with children comprising 12.9% of reported cases in the United States. In children, COVID-19 infection appears to be associated with mild respiratory symptoms; however, serious neurological complications may occur in conjunction with multisystem inflammatory syndrome. A wide spectrum of neurological diseases have been observed in children with COVID-19 infection including encephalitis, acute necrotizing encephalopathy, acute disseminated encephalomyelitis, cytotoxic lesion of the callosal splenium, posterior reversible encephalopathy syndrome, venous sinus thrombosis, vasculitis and infarction, Guillain-Barré syndrome, transverse myelitis, and myositis. This review describes the characteristic magnetic resonance neuroimaging features of these diseases and their differentiations from other imaging mimics. In addition, we review the possible pathophysiology underlying the association between these diseases and COVID-19-infection. As new SARS-CoV-2 variants emerge and COVID-19 infection continues to spread worldwide, pediatricians, radiologists, and first-line care givers should be aware of possible neurological diseases associated with COVID-19 infection when these reported neuroimaging patterns are observed in children during this pandemic.
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