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Neurological consequences of SARS-CoV-2 infections in the pediatric population
Manon Casabianca1, Caroline Caula1, Luigi Titomanlio1,2,3
1Pediatric Emergency Department, APHP - Hopital Robert Debré, Paris Cité University, Paris, France.
Insights
COVID-19 can cause non-specific neurological symptoms in 1 in 5 children, and rarer serious conditions like encephalitis in 1% of cases. These pediatric neurological issues require close monitoring due to potential complications.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- COVID-19 is often asymptomatic in children.
- A significant minority of pediatric COVID-19 cases exhibit non-specific neurological symptoms.
- Increasing reports link SARS-CoV-2 infection to severe neurological conditions in children.
Purpose of the Study:
- To summarize the spectrum of neurological manifestations in pediatric COVID-19.
- To discuss potential pathophysiological mechanisms.
- To highlight the need for monitoring and further research into long-term neurodevelopmental effects.
Main Methods:
- Literature review of reported pediatric COVID-19 cases with neurological involvement.
- Analysis of clinical presentations and outcomes.
- Discussion of proposed etiological pathways.
Main Results:
- 1 in 5 children with COVID-19 experience non-specific neurological symptoms (headache, weakness, myalgia).
- Approximately 1% of pediatric COVID-19 cases develop rarer neurological diseases (encephalitis, stroke, Guillain-Barré syndrome, etc.).
- Neurological conditions can manifest during or after SARS-CoV-2 infection.
Conclusions:
- SARS-CoV-2 infection poses a risk for diverse neurological complications in children.
- Pathophysiology involves direct viral invasion or post-infectious immune responses.
- Close monitoring is crucial for pediatric patients with neurological symptoms related to COVID-19, and long-term neurodevelopmental consequences warrant further investigation.
Abstract:
COVID-19 in the pediatric population is mostly asymptomatic. However, 1 out of 5 children presents non-specific neurologic symptoms such as headache, weakness, or myalgia. Furthermore, rarer forms of neurological diseases are increasingly being described in association to a SARS-CoV-2 infection. Encephalitis, stroke, cranial nerves impairment, Guillain-Barré syndrome or acute transverse myelitis have been reported and account for around 1% of pediatric COVID-19 cases. Some of these pathologies may occur during or after the SARS-CoV-2 infection. The pathophysiological mechanisms range from direct invasion of the central nervous system (CNS) by SARS-CoV-2 itself to postinfectious immune-mediated CNS inflammation. In most cases, patients presenting neurological pathologies related to SARS-CoV-2 infection are at greater risk of life-threatening complications and should be closely monitored. Further studies are needed to acknowledge the potential long-term neurodevelopmental consequences of the infection.
