Manifestaciones extra pulmonares COVID-19 en pediatría: reporte tres casos Hospital Edgardo Rebagliati Martins - Perú

Abstract

Resumen: El objetivo de este trabajo fue presentar una serie de casos de COVID-19 con manifestacionesextra pulmonares atípicas de la enfermedad. Los casos fueron evaluados por un equipo interdisciplinario de personal de la salud del Departamento de Pediatría del Hospital Edgardo Rebagliati Martins, de pacientes pediátricos con Covid-19, posteriormente los datos fueron tomados de la historia clínica de cada paciente. Se evaluaron tres casos, con desenlace satisfactorio. La pandemia por SARS-CoV-2 cada día cobra más vidas, por lo que se hace necesario la descripción de casos y su diversa variedad de presentación extrapulmonar, con el fin de identificar oportunamente a los infectados y tomar medidas tanto terapéuticascomo de prevención con el fin de evitar la propagación de la enfermedad y lograr su control.

Acute disseminated encephalomyelitis and COVID-19: A systematic synthesis of worldwide cases

“…In pediatric cases, nine patients with a mean age of 6.8 years (range: 0.17 to 15 years) were reported ( Abdel-Mannan et al, 2020 ; De Miranda Henriques-Souza et al, 2021 ; Dominguez-Rojas et al, 2020 ; Lindan et al, 2020 ). Non sex predominance was observed.…”

“…Data on time from COVID-19 infection to ADEM diagnosis was not available. Five patients registered COVID-19 symptoms, all of them mild or asymptomatic ( De Miranda Henriques-Souza et al, 2021 ; Dominguez-Rojas et al, 2020 ; Lindan et al, 2020 ). Comorbidities were reported only in two cases (asthma and obesity)( Abdel-Mannan et al, 2020 ; Lindan et al, 2020 ).…”

“…Seven cases (77.8%) had moderate/severe ADEM clinical presentation. The COVID-19 diagnosis was made using a PCR test or an antigen test in eight cases ( Abdel-Mannan et al, 2020 ; De Miranda Henriques-Souza et al, 2021 ; Lindan et al, 2020 ) and by serum antibody test (IgM and IgG) in one case ( Dominguez-Rojas et al, 2020 ). The result of the PCR test for COVID-19 in CSF was reported only in two cases, both negative.…”

“…The result of the PCR test for COVID-19 in CSF was reported only in two cases, both negative. Most patients developed encephalopathy (77.8%) ( N = 7/9) ( Abdel-Mannan et al, 2020 ; De Miranda Henriques-Souza et al, 2021 ; Dominguez-Rojas et al, 2020 ; Lindan et al, 2020 ) . Other neurological findings were pyramidal signs (44.4%) ( N = 4/9)( Abdel-Mannan et al, 2020 ; De Miranda Henriques-Souza et al, 2021 ; Dominguez-Rojas et al, 2020 ; Lindan et al, 2020 ), brainstem signs (11.1%) ( N = 1/9) ( De Miranda Henriques-Souza et al, 2021 ), cerebellar signs (22.2%) ( N = 2/9) ( Abdel-Mannan et al, 2020 ; Rojas et al, 2020), seizures (33.3%) ( N = 3/9) ( Lindan et al, 2020 ), and peripheral nerve compromise (11.1%) (N = 1/9) ( Abdel-Mannan et al, 2020 ).…”

“…Most patients developed encephalopathy (77.8%) ( N = 7/9) ( Abdel-Mannan et al, 2020 ; De Miranda Henriques-Souza et al, 2021 ; Dominguez-Rojas et al, 2020 ; Lindan et al, 2020 ) . Other neurological findings were pyramidal signs (44.4%) ( N = 4/9)( Abdel-Mannan et al, 2020 ; De Miranda Henriques-Souza et al, 2021 ; Dominguez-Rojas et al, 2020 ; Lindan et al, 2020 ), brainstem signs (11.1%) ( N = 1/9) ( De Miranda Henriques-Souza et al, 2021 ), cerebellar signs (22.2%) ( N = 2/9) ( Abdel-Mannan et al, 2020 ; Rojas et al, 2020), seizures (33.3%) ( N = 3/9) ( Lindan et al, 2020 ), and peripheral nerve compromise (11.1%) (N = 1/9) ( Abdel-Mannan et al, 2020 ). On the MRI, patients presented lesions in the white matter(77.8%) ( N = 7/9) ( Abdel-Mannan et al, 2020 ; De Miranda Henriques-Souza et al, 2021 ; Lindan et al, 2020 ; Dominguez- Rojas et al, 2020), deep gray matter (44.4%) (N = 4/9) ( Lindan et al, 2020 ; Dominguez-Rojas et al, 2020 ), spinal cord (44.4%) ( N = 4/9) ( Dominguez-Rojas et al, 2020 ; Lindan et al, 2020 ), brainstem (44.4%) (N = 4/9) ( Lindan et al, 2020 ) and cerebellum (22.2%) ( N = 2/9) ( Assunção et al, 2020 ; Lindan et al, 2020 ).…”