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Neuromuscular complications of severe COVID-19 in paediatric patients: Medium-term follow-up

Daniela Avila-Smirnow1, Pamela Céspedes2, Felipe Reyes3

  • 1Unidad de Neurología Pediátrica, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Región Metropolitana 8330077, Chile; Unidad de Neurología, Servicio de Pediatría, Complejo Asistencial Dr. Sótero del Río, Av. Concha y Toro 3459, Puente Alto, Región Metropolitana 8207257, Chile.

Neuromuscular Disorders : NMD
|May 13, 2022
PubMed

Insights

Neuromuscular complications like critical illness polyneuropathy and myopathy affect 11% of severe pediatric COVID-19 patients. These neurological issues in children, similar to adults, suggest an unfavorable medium-term prognosis.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Neuromuscular complications are common in adults with severe COVID-19, including critical illness polyneuropathy (CIP), critical illness myopathy (CIM), and focal neuropathies.
  • Characterization of these complications in pediatric patients with severe COVID-19 remains limited.

Observation:

  • A retrospective analysis of mechanically ventilated pediatric patients with severe COVID-19 was conducted at a single tertiary center from March 2020 to August 2021.
  • Out of 36 mechanically ventilated patients, 4 (11%) developed neuromuscular complications: one CIM, two focal neuropathies, and one CIP with plexopathy.
  • The gamma genetic variant of SARS-CoV-2 was identified in three of these patients.

Findings:

  • Pediatric patients with severe COVID-19 can experience neuromuscular complications analogous to those seen in adults.
  • The incidence of such complications in this cohort was 11%.

Implications:

  • The findings suggest that pediatric severe COVID-19 patients are susceptible to neuromuscular sequelae.
  • Medium-term follow-up revealed only slight clinical improvement in most affected children, indicating a potentially unfavorable prognosis.
  • Further research is warranted to understand the pathophysiology and long-term outcomes of these complications in pediatric populations.

Keywords:
Brachial plexus neuropathiesCOVID-19Intensive care unitsNeuromuscular manifestationsPeripheral nervous systemSevere acute respiratory syndrome

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