Neurological symptoms and signs associated with COVID-19 in pediatric patients: a single-center experience
1State Hospital of Denizli, Department of Pediatrics, Division of Pediatric Infectious Diseases, Denizli, Turkey.
Insights
Neurological effects of SARS-CoV-2 in children are understudied. This study found 14.4% of pediatric COVID-19 patients experienced neurological symptoms like headache and seizures, with higher inflammatory markers observed.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neuroscience
Background:
- Limited evidence exists regarding the neurological impact of SARS-CoV-2 (the virus causing COVID-19) on pediatric populations.
- Studies focusing on Central Nervous System (CNS) involvement in children with COVID-19 are scarce, highlighting a significant knowledge gap.
Purpose of the Study:
- To identify and characterize neurological signs and symptoms in pediatric patients diagnosed with COVID-19.
- To manage identified neurological manifestations during follow-up and inform future care strategies for affected children.
Main Methods:
- A retrospective study included 243 hospitalized pediatric COVID-19 patients (March 2020-June 2021), excluding those with pre-existing neurological conditions.
- Patients were categorized into two groups: those with and without neurological findings.
- Data were collected from hospital files and medical records for analysis.
Main Results:
- Neurological findings were present in 35 (14.4%) of the pediatric patients.
- The most common neurological manifestations included headache (7%) and anosmia/hyposmia (7%), followed by seizures (1.6%).
- Group 1 (with neurological findings) exhibited elevated leukocyte, lymphocyte, thrombocyte, AST, LDH, and d-dimer levels, suggesting systemic inflammation.
Conclusions:
- Neurological involvement is a notable complication of COVID-19 in children, manifesting as headaches, anosmia/hyposmia, and seizures.
- Girls and older children (over 9 years) were more frequently affected by anosmia and headache, respectively.
- Pulmonary and hematologic involvement were more prevalent in children experiencing anosmia and headache, indicating potential links between neurological and systemic manifestations.
Abstract:
There is insufficient evidence on SARS-CoV-2 induced neurological effects. Studies on CNS involvement during COVID-19 in children are limited. This study aims to identify and manage the neurological signs and symptoms in COVID-19-infected pediatric patients during follow up and plan future follow-ups. Children diagnosed COVID-19 and hospitalized in the pediatric pandemic services, between March 18, 2020, and June 18, 2021, were included in the study. Children with underlying neurological disease were excluded from the study. Patient data retrieved from hospital files and medical records. Children divided into 2 groups, 1 and 2, based on the presence or absence of neurological findings. A total of 243 children received follow-ups in the pandemic wards, 35 (14.4%) of these patients had neurological findings. Major neurological manifestations were headache (n:17, 7%), seizure (n:4, 1.6%), and anosmia/hyposmia (n:17, 7%). The number of boys (n:13, 37.1%) was smaller than the number of girls (n:22, 62.9%) in Group 1. Group 1 showed higher blood leukocyte, lymphocyte, thrombocyte, AST, LDH, d-dimer values. Anosmia/hyposmia occurred more often in girls, anosmia and headache occurred more often over 9 years of age. Pulmonary and hematologic involvement was more common in children with anosmia and headache. Our study is one of the few studies on neurological involvement in COVID-19 in children. To the best of our knowledge, there is limited data on these subjects in the literature.
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