COVID-19 and the Pediatric Nervous System: Global Collaboration to Meet a Global Need

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has affected mortality and morbidity across all ages, including children. It is now known that neurological manifestations of COVID-19, ranging from headaches to stroke, may involve the central and/or peripheral nervous system at any age. Neurologic involvement is also noted in the multisystem inflammatory syndrome in children, a pediatric condition that occurs weeks after infection with the causative virus of COVID-19, severe acute respiratory syndrome coronavirus 2. Knowledge about mechanisms of neurologic disease is scarce but rapidly growing. COVID-19 neurologic manifestations may have particularly adverse impacts on the developing brain. Emerging data suggest a cohort of patients with COVID-19 will have longitudinal illness affecting their cognitive, physical, and emotional health, but little is known about the long-term impact on affected children and their families. Pediatric collaboratives have begun to provide important initial information on neuroimaging manifestations and the incidence of ischemic stroke in children with COVID 19. The Global Consortium Study of Neurologic Dysfunction in COVID-19-Pediatrics, a multinational collaborative, is working to improve understanding of the epidemiology, mechanisms of neurological manifestations, and the long-term implications of COVID-19 in children and their families.

Neurological effects of COVID‐19 in infants and children

“…Several attempts to standardize these confounders are underway by establishing national and international consortia, which should provide a clearer picture over time. 113 Much more pediatric data are needed from neuroimaging, neuropathological, and ancillary studies (e.g. CSF, electrophysiology).…”

Biobehavioral Implications of Covid-19 for Transplantation and Cellular Therapy Recipients

“…For children and adolescents, there are likely significant implications of experiencing these inflammatory insults during critical developmental periods. Indeed, there are reports of prolonged neurocognitive deficits and adverse QOL in pediatric Covid-19 survivors ( 154 , 155 ). There is a scarcity of data regarding severe Covid-19 in pediatric patients with baseline dysregulated immune systems, and the long-term neuropsychiatric sequelae of severe inflammation associated with SARS-CoV-2 infection in young cellular therapy patients should be an area of active research focus.…”

Cerebrovascular Complications in Pediatric Patients with COVID-19 Infection

“…These can be divided into direct or secondary viral involvement. [22][23][24][25][26][27][28][29][30] While further research is needed for validation, the underlying pathophysiology is favored to be multifactorial, and more than one mechanism is likely responsible for the broad range of cerebrovascular complications seen with SARS-CoV-2. 3,7,[31][32][33][34] Direct neuroinvasion by COVID-19 has been suspected since the initial identification of SARS-CoV-2 RNA within the cerebrospinal fluid (CSF) of infected patients.…”

“…These can be divided into direct or secondary viral involvement. 22 23 24 25 26 27 28 29 30 While further research is needed for validation, the underlying pathophysiology is favored to be multifactorial, and more than one mechanism is likely responsible for the broad range of cerebrovascular complications seen with SARS-CoV-2. 3 7 31 32 33 34…”