Neurologic Care of COVID-19 in Children

Abstract

Most children with SARS-CoV-2 infection have relatively mild clinical symptoms without fever or pneumonia, although severe cases with multiple-organ failure have been reported. Neurological symptoms, which have been mainly reported in adults, are very rare in children. This article will review 2 different aspects of neurological involvement related to this infection in children. In the first part, we will review the neurological abnormalities reported in children caused by this viral infection. Adults frequently report muscle pain, headache, anosmia, dysgeusia, and occasionally more severe central or peripheral nervous system damage. Neurological involvement seems infrequent in children, although some cases have been reported. In the second part, we will discuss the COVID-19 pandemic impact on the healthcare system of some countries, causing collateral damage to general pediatric care and in particular to those children affected with chronic diseases, mainly neurological conditions, including autism, intellectual disability, attention deficit and hyperactivity disorder (ADHD), neuromuscular disorders, cerebral palsy, and epilepsy, and patients needing neurosurgical procedures.

Progress in the Diagnosis and Treatment of COVID-19 in Children: A Review

“… 32 Children have relatively fewer neurological complications after infection with SARS-CoV-2 compared with adults. 76 Neurological symptoms are mainly non-specific symptoms such as headaches, and the incidence of severe symptoms and specific complications is only about 1%. 76 This also causes respiratory Children with insignificant symptoms are easily misdiagnosed and missed.…”

“… 76 Neurological symptoms are mainly non-specific symptoms such as headaches, and the incidence of severe symptoms and specific complications is only about 1%. 76 This also causes respiratory Children with insignificant symptoms are easily misdiagnosed and missed. 77 Children with severe infections may develop acute respiratory distress syndrome, septic shock, metabolic acidosis and coagulopathy.…”

“… 72 In addition, neurological complications that are rarely seen in children infected with SARS-CoV-2 are particularly likely to occur in SARS-CoV-2 infected children with MIS-C, among which encephalopathy is more common, sometimes accompanied by transient symptomatic seizures, but without long-term neurological sequelae. 76 Therefore, the possibility of being one of the clinical manifestations of MIS-C should be considered in any child presenting with primary neurological symptoms, accompanied by fever and mild or no respiratory symptoms in an endemic area of COVID-19. In addition, serum albumin levels 13 and croup 80 can also be closely monitored as predictive indicators of MIS-C. Due to most children with MIS-C have mild or no symptoms when initially infected with COVID-19, and high vigilance is needed for MIS-C. 81 …”

Is Acute Solid Food Aversion a Proxy for COVID-19–Related Olfactory and Gustatory Dysfunction?

“…A variety of other neurologic and mental health complications of COVID have been reported in both pediatric and adult populations. [12][13] We cannot at this time determine if this finding is or is not independent of the COVID infection and more pediatric data is needed.…”

COVID-19 and neurologic manifestations: a synthesis from the child neurologist’s corner

“…They frequently present with hypoxia, fever, and hypotension. All of these factors may cause diverse neurologic symptoms, such as seizures and encephalopathy [ 5 , 95 , 98 – 102 ].…”