Encephalitis Associated with COVID-19 Infection in an 11-Year-Old Child

McAbee, Gary N.; Brosgol, Yuri; Pavlakis, Steven G.; Agha, Rabia; Gaffoor, Mohamed

doi:10.1016/j.pediatrneurol.2020.04.013

Cited by 139 publications

(148 citation statements)

References 7 publications

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“…Another case series showed that de novo SE can be the initial presentation in patients presenting with altered mental status, but otherwise asymptomatic COVID-19. McAbee et al [ 66 ] reported a COVID-19 case with SE and CSF evidence for encephalitis in an 11-year-old male presenting with generalized weakness.…”

Section: Cns Manifestations Associated With Covid-19mentioning

confidence: 99%

“…Dugu et al [ 134 ] reported a 6-week-old COVID-19 case presenting with cough, fever, and two brief episodes (10–15 s) of upward gaze and bilateral leg stiffening. McAbee et al [ 66 ] reported an 11-year-old male COVID-19 case with SE and CSF evidence for encephalitis. The patient experienced a 2-day generalized weakness.…”

Section: Cns Manifestations Associated With Covid-19mentioning

confidence: 99%

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Central Nervous System Manifestations Associated with COVID-19

Divani

Andalib

Biller

et al. 2020

Curr Neurol Neurosci Rep

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Purpose of Review Coronavirus disease 2019 (COVID-19) has become a global health crisis of our time. The disease arises from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that binds to angiotensin-converting enzyme 2 (ACE2) receptors on host cells for its internalization. COVID-19 has a wide range of respiratory symptoms from mild to severe and affects several other organs, increasing the complexity of the treatment. There is accumulating evidence to suggest that SARS-CoV-2 can target the nervous system. In this review, we provide an account of the COVID-19 central nervous system (CNS) manifestations. Recent Findings A broad spectrum of the CNS manifestations including headache, impaired consciousness, delirium, loss of smell and taste, encephalitis, seizures, strokes, myelitis, acute disseminated encephalomyelitis, neurogenic respiratory failure, encephalopathy, silent hypoxemia, generalized myoclonus, neuroleptic malignant syndrome and Kawasaki syndrome has been reported in patients with COVID-19. Summary CNS manifestations associated with COVID-19 should be considered in clinical practice. There is a need for modification of current protocols and standing orders to provide better care for COVID-19 patients presenting with neurological symptoms.

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Section: Cns Manifestations Associated With Covid-19mentioning

confidence: 99%

Section: Cns Manifestations Associated With Covid-19mentioning

confidence: 99%

Central Nervous System Manifestations Associated with COVID-19

Divani

Andalib

Biller

et al. 2020

Curr Neurol Neurosci Rep

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“…Pediatric observational studies published early in the pandemic across China in February 2020 reported similar ndings with fever being the most common symptom followed by cough and sore throat. 6,7,8 However, as the pandemic progressed, newer 'atypical' manifestations were witnessed across different continents in the form of cutaneous exanthems, 9,10 encephalitis, 11,12 and myocarditis. 13,14 In this study, all 50 (100%) cases recovered completely with no morbidities.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological and clinical characteristics of COVID-19 in Indian children in the initial phase of the pandemic: A cross-sectional study

Sarangi

Reddy

Oswal

et al. 2020

Preprint

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Background: India saw the largest and the most stringent lockdown in the world when the number of COVID-19 cases reached around 550. With some early benefits in containing the surge and restricting the R0 of the virus, the current relaxation of lockdown norms has witnessed an exponential rise in positive cases. With scarcity of Pediatric data from the Indian subcontinent, early observations in the pandemic are pivotal in improving the understanding of physiologic behaviors, identifying risks, and guiding clinicians in assessing time-tested interventions and augmenting the awareness in the masses about the manifold clinical profiles of an evolving disease.Objective: To assess the epidemiological and clinical characteristics of children admitted with COVID-19 infection early in the pandemic.Study Design: A cross-sectional studyParticipants: Fifty children between one month and 18 years of age whose nasopharyngeal swab tested positive for SARS-CoV-2 by RT- PCR. Results: 28 (56%) children were male. 41 (82%) came from government declared containment zones with only one child having history of travel to affected area. Home overcrowding was observed in 33 (66%). Of the 50 children, 29 (58%) were asymptomatic while 20 (40%) and one (2%) had mild and moderate symptoms respectively. Fever, cough, and sore throat were the most common symptoms. 49 (98%) children had BCG scar. Leucopenia was seen in three (6%) only. Mean (SD) Neutrophil-Lymphocyte-Ratio (NLR) was 0.78 (0.48) while mean (SD) CRP was 10.98 (23.90). All 50 (100%) were cured. Conclusion: Our study reasserts the increasing pediatric burden of COVID-19 with all age groups affected and overcrowding as a risk factor for continued community transmission, thus beckoning that public health policies be directed to ensuring further preventive measures. It also re-iterates the milder disease pattern in children with COVID-19 in the initial phase of the pandemic with a high proportion of asymptomatic and mild illness. Though abnormal CRP values are synonymous with the illness in children; leucopenia may not be a consistent finding.

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“…Inflammatory conditions leading to increased IL-6 and TNF-α also might facilitate disruption of BBB ( Ichiyama et al, 2002 ; Linker et al, 2008 ) which in turn might be responsible for encephalitis, acute necrotizing encephalopathy and demyelination in the CNS and even Guillain-Barré syndrome (GBS) in the PNS. There are several case reports of such complications due to SARS-CoV-2 infection as we discuss in the next sections ( Alberti et al, 2020 ; McAbee et al, 2020 ; Moriguchi et al, 2020 ; Poyiadji et al, 2020 ; Zanin et al, 2020 ; Zhang et al, 2020d ). Interestingly, tocilizumab (a recombinant, humanized monoclonal antibody against the IL-6 receptor), which is an FDA approved medication for treatment of T cell induced CRS, also showed some benefit over severe cases of COVID-19 infection ( Le et al, 2018 ; Xu et al, 2020a ).…”

Section: Mechanisms Of Cns Involvementmentioning

confidence: 99%

SARS-CoV-2 and nervous system: From pathogenesis to clinical manifestation

Keyhanian

Umeton

Mohit

et al. 2021

Journal of Neuroimmunology

121

146

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Since the coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a growing body of evidence indicates that besides common COVID-19 symptoms, patients may develop various neurological manifestations affecting both the central and peripheral nervous systems as well as skeletal muscles. These manifestations can occur prior, during and even after the onset of COVID-19 general symptoms. In this Review, we discuss the possible neuroimmunological mechanisms underlying the nervous system and skeletal muscle involvement, and viral triggered neuroimmunological conditions associated with SARS-CoV-2, as well as therapeutic approaches that have been considered for these specific complications worldwide.

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Encephalitis Associated with COVID-19 Infection in an 11-Year-Old Child

Cited by 139 publications

References 7 publications

Central Nervous System Manifestations Associated with COVID-19

Central Nervous System Manifestations Associated with COVID-19

Epidemiological and clinical characteristics of COVID-19 in Indian children in the initial phase of the pandemic: A cross-sectional study

SARS-CoV-2 and nervous system: From pathogenesis to clinical manifestation

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