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Article ; Online: Neurological Complications of COVID-19 in Children.

Ahmad, Saba

2021 Volume 50, Issue 6, Page(s) e259–e263

Abstract: Neurological complications of coronavirus disease 2019 (COVID-19) are highly variable and can be ... in adults with COVID-19 may help facilitate the understanding of those complications that may present ... numbers of children with these complications, a comprehensive review of neurological presentations ...

Abstract	Neurological complications of coronavirus disease 2019 (COVID-19) are highly variable and can be quite severe, but they are rare in children. A careful understanding of the variety of presentations of neurological symptoms related to COVID-19 is critical for the effective management of these patients. Given the smaller numbers of children with these complications, a comprehensive review of neurological presentations in adults with COVID-19 may help facilitate the understanding of those complications that may present in children and how these presentations may be similar.
MeSH term(s)	COVID-19/complications ; COVID-19/psychology ; Child ; Humans ; Nervous System Diseases/etiology ; Nervous System Diseases/microbiology ; SARS-CoV-2
Language	English
Publishing date	2021-06-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	195430-1
ISSN	1938-2359 ; 0090-4481
ISSN (online)	1938-2359
ISSN	0090-4481
DOI	10.3928/19382359-20210517-01
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Article ; Online: Neurological complications of COVID-19 in children and the associated immunological responses.

Siddique, Rabeea / Khan, Suliman / Shabana / Li, Manqi / Xue, Mengzhou / Ghanim, K Al / Kaimkhani, Zahid Ali / Mahboob, Shahid

Journal of King Saud University. Science

2022 Volume 34, Issue 3, Page(s) 101884

Abstract: ... COVID-19 induces mild to severe neurological problems in children, such as stroke, encephalopathy, mild ... to the world. It is thought that COVID-19 causes mild symptoms or mild infectious illness in children ... neurological and immunological complications in children. ...

Abstract	The high spread rate, severe symptoms, psychological and neurological problems, and unavailability of effective medicines are the major factors making Coronavirus disease 2019 (COVID-19) a massive threat to the world. It is thought that COVID-19 causes mild symptoms or mild infectious illness in children. However, we cannot rule out the possibility of serious complications such as the multisystem inflammatory syndrome. COVID-19 induces mild to severe neurological problems in children, such as stroke, encephalopathy, mild shortness of breath, and myalgia. The development of these conditions is associated with pro-inflammatory responses and cytokine storms, which alter the physiology of the blood-brain barrier and allow the virus to enter the brain. Despite the viral entry into the brain, these neurological conditions can also be caused indirectly by severe immune responses. In this article, we describe COVID-19 and the associated neurological and immunological complications in children.
Language	English
Publishing date	2022-02-08
Publishing country	Saudi Arabia
Document type	Journal Article ; Review
ISSN	2213-686X
ISSN (online)	2213-686X
DOI	10.1016/j.jksus.2022.101884
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Article ; Online: Post-COVID-19 Immune-Mediated Neurological Complications in Children: An Ambispective Study.

Saini, Lokesh / Krishna, Deepthi / Tiwari, Sarbesh / Goyal, Jagdish Prasad / Kumar, Prawin / Khera, Daisy / Choudhary, Bharat / Didel, Siyaram / Gadepalli, Ravisekhar / Singh, Kuldeep

Pediatric neurology

2022 Volume 136, Page(s) 20–27

Abstract: ... seen in children. A temporal correlation was noted between the COVID-19 infection and the increasing ... COVID-19) infection or exposure and positive SARS-CoV-2 serology. The neuroradiological manifestations ... to understand the varied neurological manifestations following SARS-CoV-2 infection in children. ...

Abstract	Background: The neurological manifestation following a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is varied, and till now, only a few studies have reported the same. Methods: We used retrospective data from May to July 2021 and prospective study data from August to September 2021, including that from children aged between one month and 18 years who presented to a tertiary care referral center with the neurological manifestation and had a history of coronavirus disease 2019 (COVID-19) infection or exposure and positive SARS-CoV-2 serology. The neuroradiological manifestations were further categorized as in a predesigned proforma. Results: Case records of the 18 children who fulfilled the criteria were included in the study; among them, seven (38.8%) were male and 11 (61.1%) were female. Predominant presentation in our study group was status epilepticus (six of 18) and Guillain-Barré syndrome (five of 18). Other manifestations included stroke (two of 18), demyelinating syndromes (three of 18), and autoimmune encephalitis (two of 18). Most of the children had favorable outcomes except for one mortality in our cohort. Conclusions: Delayed complications following SARS-CoV-2 infection are seen in children. A temporal correlation was noted between the COVID-19 infection and the increasing number of neurological cases after the second wave. Steroids could be beneficial while treating such patients, especially in the presence of high inflammatory markers. Testing for SARS-CoV-2 serology during the pandemic can give a clue to the underlying etiology. Further multicentric studies are required to understand the varied neurological manifestations following SARS-CoV-2 infection in children.
MeSH term(s)	COVID-19/complications ; Child ; Female ; Guillain-Barre Syndrome/etiology ; Humans ; Infant ; Male ; Nervous System Diseases/epidemiology ; Pandemics ; Prospective Studies ; Retrospective Studies ; SARS-CoV-2
Language	English
Publishing date	2022-07-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	639164-3
ISSN	1873-5150 ; 0887-8994
ISSN (online)	1873-5150
ISSN	0887-8994
DOI	10.1016/j.pediatrneurol.2022.06.010
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Article ; Online: Neurological complications of COVID-19 in children and the associated immunological responses

Rabeea Siddique / Suliman Khan / Shabana / Manqi Li / Mengzhou Xue / K.Al. Ghanim / Zahid Ali Kaimkhani / Shahid Mahboob

Journal of King Saud University: Science, Vol 34, Iss 3, Pp 101884- (2022)

2022

Abstract	The high spread rate, severe symptoms, psychological and neurological problems, and unavailability of effective medicines are the major factors making Coronavirus disease 2019 (COVID-19) a massive threat to the world. It is thought that COVID-19 causes mild symptoms or mild infectious illness in children. However, we cannot rule out the possibility of serious complications such as the multisystem inflammatory syndrome. COVID-19 induces mild to severe neurological problems in children, such as stroke, encephalopathy, mild shortness of breath, and myalgia. The development of these conditions is associated with pro-inflammatory responses and cytokine storms, which alter the physiology of the blood–brain barrier and allow the virus to enter the brain. Despite the viral entry into the brain, these neurological conditions can also be caused indirectly by severe immune responses. In this article, we describe COVID-19 and the associated neurological and immunological complications in children.
Keywords	COVID-19 ; Children ; Immune ; Neurologica ; Viral transmission ; Science (General) ; Q1-390
Subject code	616
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
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Article ; Online: The COVID-19 infection in children and its association with the immune system, prenatal stress, and neurological complications.

Khan, Suliman / Siddique, Rabeea / Hao, Xiao / Lin, Yueting / Liu, Yuxin / Wang, Xiaoyan / Hua, Linlin / Nabi, Ghulam

International journal of biological sciences

2022 Volume 18, Issue 2, Page(s) 707–716

Abstract: ... neurological complications, and other associated problems. Although COVID-19 generally causes mild and ... importantly, SARS-CoV-2 can cause neurological complications in children, such as shortness of breath, myalgia ... recoverable symptoms in children, it can cause serious severe symptoms and death causing complications. Most ...

Abstract	The Coronavirus disease 2019 (COVID-19)" caused by the "severe acute respiratory syndrome corona virus 2 (SARS-CoV-2)" has caused huge losses to the world due to the unavailability of effective treatment options. It is now a serious threat to humans as it causes severe respiratory disease, neurological complications, and other associated problems. Although COVID-19 generally causes mild and recoverable symptoms in children, it can cause serious severe symptoms and death causing complications. Most importantly, SARS-CoV-2 can cause neurological complications in children, such as shortness of breath, myalgia, stroke, and encephalopathy. These problems are highly linked with cytokine storm and proinflammatory responses, which can alter the physiology of the blood-brain barrier and allow the virus to enter the brain. Despite the direct infection caused by the virus entry into the brain, these neurological complications can result from indirect means such as severe immune responses. This review discusses viral transmission, transport to the brain, the associated prenatal stress, and neurological and/or immunological complications in children.
MeSH term(s)	COVID-19/complications ; COVID-19/immunology ; COVID-19/pathology ; Central Nervous System Diseases/etiology ; Child ; Female ; Humans ; Infectious Disease Transmission, Vertical ; Pregnancy ; Prenatal Exposure Delayed Effects ; SARS-CoV-2
Language	English
Publishing date	2022-01-01
Publishing country	Australia
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2179208-2
ISSN	1449-2288 ; 1449-2288
ISSN (online)	1449-2288
ISSN	1449-2288
DOI	10.7150/ijbs.66906
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Article ; Online: Neurological Complications of Malaria.

Trivedi, Sweety / Chakravarty, Ambar

Current neurology and neuroscience reports

2022 Volume 22, Issue 8, Page(s) 499–513

Abstract: ... cerebellar ataxia. Lastly, the impact of the COVID-19 pandemic on worldwide malaria control programs and ... but remains localized only to the central nervous system (CNS) among African children. Neurological sequelae ... Purpose of review: To discuss the neurological complications and pathophysiology of organ damage ...

Abstract	Purpose of review: To discuss the neurological complications and pathophysiology of organ damage following malaria infection. Recent findings: The principal advancement made in malaria research has been a better understanding of the pathogenesis of cerebral malaria (CM), the most dreaded neurological complication generally caused by Plasmodium falciparum infection. However, no definitive treatment has yet been evolved other than the use of antimalarial drugs and supportive care. The development of severe cerebral edema in CM results from two distinct pathophysiologic mechanisms. First, the development of "sticky" red blood cells (RBCs) leads to cytoadherence, where red blood cells (RBCs) get stuck to the endothelial walls and between themselves, resulting in clogging of the brain microvasculature with resultant hypoxemia and cerebral edema. In addition, the P. falciparum-infected erythrocyte membrane protein 1 (PfEMP1) molecules protrude from the raised knob structures on the RBCs walls and are in themselves made of a combination of human and parasite proteins in a tight complex. Antibodies to surfins, rifins, and stevors from the parasite are also located in the RBC membrane. On the human microvascular side, a range of molecules involved in host-parasite interactions, including CD36 and intracellular adhesion molecule 1, is activated during interaction with other molecules such as endothelial protein C receptor and thrombospondin. As a result, an inflammatory response occurs with the dysregulated release of cytokines (TNF, interleukins 1 and 10) which damage the blood-brain barrier (BBB), causing plasma leakage and brain edema. This second mechanism of CNS injury often involves multiple organs in adult patients in endemic areas but remains localized only to the central nervous system (CNS) among African children. Neurological sequelae may follow both P. falciparum and P. vivax infections. The major brain pathology of CM is brain edema with diffuse brain swelling resulting from the combined effects of reduced perfusion and hypoxemia of cerebral neurons due to blockage of the microvasculature by parasitized RBCs as well as the neurotoxic effect of released cytokines from a hyper-acute immune host reaction. A plethora of additional neurological manifestations have been associated with malaria, including posterior reversible encephalopathy syndrome (PRES), reversible cerebral vasoconstriction syndrome (RCVS), malarial retinopathy, post-malarial neurological syndrome (PMNS), acute disseminated encephalomyelitis (ADEM), Guillain-Barré syndrome (GBS), and cerebellar ataxia. Lastly, the impact of the COVID-19 pandemic on worldwide malaria control programs and the possible threat from co-infections is briefly discussed.
MeSH term(s)	Adult ; Brain Edema ; COVID-19 ; Child ; Cytokines ; Humans ; Hypoxia ; Malaria, Cerebral/complications ; Malaria, Cerebral/parasitology ; Malaria, Falciparum/complications ; Malaria, Falciparum/parasitology ; Pandemics ; Plasmodium falciparum/physiology ; Posterior Leukoencephalopathy Syndrome
Chemical Substances	Cytokines
Language	English
Publishing date	2022-06-14
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057363-7
ISSN	1534-6293 ; 1528-4042
ISSN (online)	1534-6293
ISSN	1528-4042
DOI	10.1007/s11910-022-01214-6
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Article ; Online: Neurological manifestations of COVID-19 in adults and children.

Cho, Sung-Min / White, Nicole / Premraj, Lavienraj / Battaglini, Denise / Fanning, Jonathon / Suen, Jacky / Bassi, Gianluigi Li / Fraser, John / Robba, Chiara / Griffee, Matthew / Singh, Bhagteshwar / Citarella, Barbara Wanjiru / Merson, Laura / Solomon, Tom / Thomson, David

Brain : a journal of neurology

2022 Volume 146, Issue 4, Page(s) 1648–1661

Abstract: Different neurological manifestations of coronavirus disease 2019 (COVID-19) in adults and children ... 161 239 patients (158 267 adults; 2972 children) hospitalized with COVID-19 and assessed ... of neurological manifestations and in-hospital complications among hospitalized COVID-19 patients and ascertain differences ...

Abstract	Different neurological manifestations of coronavirus disease 2019 (COVID-19) in adults and children and their impact have not been well characterized. We aimed to determine the prevalence of neurological manifestations and in-hospital complications among hospitalized COVID-19 patients and ascertain differences between adults and children. We conducted a prospective multicentre observational study using the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) cohort across 1507 sites worldwide from 30 January 2020 to 25 May 2021. Analyses of neurological manifestations and neurological complications considered unadjusted prevalence estimates for predefined patient subgroups, and adjusted estimates as a function of patient age and time of hospitalization using generalized linear models. Overall, 161 239 patients (158 267 adults; 2972 children) hospitalized with COVID-19 and assessed for neurological manifestations and complications were included. In adults and children, the most frequent neurological manifestations at admission were fatigue (adults: 37.4%; children: 20.4%), altered consciousness (20.9%; 6.8%), myalgia (16.9%; 7.6%), dysgeusia (7.4%; 1.9%), anosmia (6.0%; 2.2%) and seizure (1.1%; 5.2%). In adults, the most frequent in-hospital neurological complications were stroke (1.5%), seizure (1%) and CNS infection (0.2%). Each occurred more frequently in intensive care unit (ICU) than in non-ICU patients. In children, seizure was the only neurological complication to occur more frequently in ICU versus non-ICU (7.1% versus 2.3%, P < 0.001). Stroke prevalence increased with increasing age, while CNS infection and seizure steadily decreased with age. There was a dramatic decrease in stroke over time during the pandemic. Hypertension, chronic neurological disease and the use of extracorporeal membrane oxygenation were associated with increased risk of stroke. Altered consciousness was associated with CNS infection, seizure and stroke. All in-hospital neurological complications were associated with increased odds of death. The likelihood of death rose with increasing age, especially after 25 years of age. In conclusion, adults and children have different neurological manifestations and in-hospital complications associated with COVID-19. Stroke risk increased with increasing age, while CNS infection and seizure risk decreased with age.
MeSH term(s)	Humans ; Adult ; Child ; COVID-19/complications ; COVID-19/epidemiology ; SARS-CoV-2 ; Stroke/complications ; Seizures/epidemiology ; Seizures/etiology ; Myalgia
Language	English
Publishing date	2022-08-26
Publishing country	England
Document type	Multicenter Study ; Observational Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	80072-7
ISSN	1460-2156 ; 0006-8950
ISSN (online)	1460-2156
ISSN	0006-8950
DOI	10.1093/brain/awac332
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Article ; Online: Psychiatric and neurological complications of long COVID.

Zawilska, Jolanta B / Kuczyńska, Katarzyna

Journal of psychiatric research

2022 Volume 156, Page(s) 349–360

Abstract: COVID-19 was primarily considered a pulmonary disease with extrapulmonary manifestations ... a minority of COVID-19 cases, so not surprisingly data on the long-term sequelae after SARS-CoV-2 infections ... of the acute phase of COVID-19 have been largely explained, these areas are yet to be explored in long COVID ...

Abstract	COVID-19 was primarily considered a pulmonary disease with extrapulmonary manifestations. As the pandemic spread, there has been growing evidence that the disease affects various organs/systems, including the central and peripheral nervous systems. Accumulation of clinical data demonstrates that in a large population of survivors impairments in the function of one or more organs may persist for a long time, a phenomenon commonly known as post COVID or long COVID. Fatigue and cognitive dysfunction, such as concentration problems, short-term memory deficits, general memory loss, a specific decline in attention, language and praxis abilities, encoding and verbal fluency, impairment of executive functions, and psychomotor coordination, are amongst the most common and debilitating features of neuropsychatric symptoms of post COVID syndrome. Several patients also suffer from compromised sleep, depression, anxiety and post-traumatic stress disorder. Patients with long COVID may demonstrate brain hypometabolism, hypoperfusion of the cerebral cortex and changes in the brain structure and functional connectivity. Children and adolescents represent a minority of COVID-19 cases, so not surprisingly data on the long-term sequelae after SARS-CoV-2 infections in these age groups are scarce. Although the pathogenesis, clinical characteristics, epidemiology, and risk factors of the acute phase of COVID-19 have been largely explained, these areas are yet to be explored in long COVID. This review aims to provide an update on what is currently known about long COVID effects on mental health.
MeSH term(s)	Child ; Humans ; Adolescent ; Post-Acute COVID-19 Syndrome ; COVID-19/complications ; SARS-CoV-2
Language	English
Publishing date	2022-10-20
Publishing country	England
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	3148-3
ISSN	1879-1379 ; 0022-3956
ISSN (online)	1879-1379
ISSN	0022-3956
DOI	10.1016/j.jpsychires.2022.10.045
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Article: Neurological Manifestations of SARS-CoV2 Infection: A Narrative Review.

Pavel, Bogdan / Moroti, Ruxandra / Spataru, Ana / Popescu, Mihaela Roxana / Panaitescu, Anca Maria / Zagrean, Ana-Maria

Brain sciences

2022 Volume 12, Issue 11

Abstract: The COVID-19 virus frequently causes neurological complications. These have been described ... the latest literature describing the relationship between COVID-19 infection and the central nervous system ... with COVID-19, including clinical signs and symptoms, imaging abnormalities, and the pathophysiology of SARS ...

Abstract	The COVID-19 virus frequently causes neurological complications. These have been described in various forms in adults and children. Headache, seizures, coma, and encephalitis are some of the manifestations of SARS-CoV-2-induced neurological impairment. Recent publications have revealed important aspects of viral pathophysiology and its involvement in nervous-system impairment in humans. We evaluated the latest literature describing the relationship between COVID-19 infection and the central nervous system. We searched three databases for observational and interventional studies in adults published between December 2019 and September 2022. We discussed in narrative form the neurological impairment associated with COVID-19, including clinical signs and symptoms, imaging abnormalities, and the pathophysiology of SARS-CoV2-induced neurological damage.
Language	English
Publishing date	2022-11-12
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2651993-8
ISSN	2076-3425
ISSN	2076-3425
DOI	10.3390/brainsci12111531
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Article: Severe Neurological Manifestation in a Child with Multisystem Inflammatory Syndrome.

Santos, Mônica de Oliveira / Ribeiro, Diuly Caroline / Rocha, Jordanna Sousa / Maia, Sibely Braga Santos / Moreira, André Luís Elias / Silva, Paulo Alex Neves / Ito, Célia Regina Malveste / Carneiro, Lilian Carla / Avelino, Melissa Ameloti Gomes

Children (Basel, Switzerland)

2022 Volume 9, Issue 11

Abstract: Background and objectives: During the COVID-19 pandemic, we followed with concern the evolution ... of several children diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C). The purpose of this study is ... medical report of all children admitted with suspected MIS-C to the five largest regional hospitals ...

Abstract	Background and objectives: During the COVID-19 pandemic, we followed with concern the evolution of several children diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C). The purpose of this study is to describe the evolution of MIS-C in a previously healthy 3-year-old girl. Methods: We tracked the daily medical report of all children admitted with suspected MIS-C to the five largest regional hospitals. Results: Our screening identified a child who had several neurological complications associated with MIS-C. We report hematological alterations, transient cardiac dysfunction, and cerebral involvements such as laminar cortical necrosis caused by ischemic stroke. We present the course of treatment and clinical outcome, and other complications such as a severe subglottic stenosis occurring after extubation. Conclusion: Subglottic stenosis is an expected complication after prolonged intubation, and the presence of dysphonia and/or stridor is an important predictive factor. MIS-C with severe neurological alteration may occur in a healthy child, and early diagnosis and treatment with a pulse of corticoid with immunoglobulin are essential for a favorable outcome.
Language	English
Publishing date	2022-10-29
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children9111653
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