Neurological Manifestations of Pediatric Acute COVID Infections: A Single Center Experience

Abstract

Background Coronavirus disease 2019 (COVID-19) usually leads to a mild infectious disease course in children, while serious complications may occur in conjunction with both acute infection and neurological symptoms, which have been predominantly reported in adults. The neurological complications in these patients vary based on patient age and underlying comorbidities. Data on clinical features, particularly neurological features, and prognostic factors in children and adolescents are limited. The present study provides a concise overview of neurological complications in pediatric COVID-19 cases. Materials and Methods The retrospective study reviewed medical records of all patients who were admitted to our hospital and were diagnosed with COVID-19 by real-time reverse-transcription polymerase-chain-reaction (RT-PCR) assay between March 11, 2020 and January 30, 2021. Patients with a positive PCR result were categorized into two groups: Out Patient Departments (OPD) patients and In Patient Departments (IPD). Results Of the 2,530 children who underwent RT-PCR during the study period, 382 (8.6%) were confirmed as COVID-19 positive, comprising 188 (49.2%) girls and 194 (50.8%) boys with a mean age of 7.14±5.84 (range, 0-17) years. Neurological complications that required hospitalization were present in 34 (8.9%) patients, including seizure (52.9%), headache (38.2%), dizziness (11.1%) and meningoencephalitis (%5.8). Conclusion The results indicated that neurological manifestations are not rare in children suffering from COVID-19. Seizures, headaches, dizziness, anosmia, ageusia, and meningoencephalitis major neurological manifestations during acute COVID-19 disease. Although seizures were the most common cause of hospitalization in IPD patients, the frequency of meningoensalitis was quite high. Seizures were observed as febrile seizures for children under six years of age and afebrile seizures for those over 6 years of age. Febrile seizure accounted for half of all seizure children.

Acute Neurological Presentation in Children With SARS-CoV-2 Infection

“…Few reports of real-time PCR (RT-PCR) SARS-CoV-2-positive children experiencing epileptic seizures are currently available in the literature (29,(38)(39)(40)(41). In our cohort, 2 patients were presented at the ED with seizures; one experiencing seizures re-exacerbation despite being previously well-controlled with a single ASM, the other with newly-onset seizure within the context of a malacic region due to a previous ischemic stroke.…”

Neurological symptoms and signs associated with COVID-19 in pediatric patients: a single-center experience

“…Notably, neurological findings are more common in obese patients in the literature. [6,9–12,15,23,26,53–55]…”

A bibliometric analysis of COVID-19 publications in neurology by using the visual mapping method

“…Kurd et al ( 81 ) pointed out that seizures occurred in an early phase once children were infected with SARS-CoV-2 and may be the main manifestation of acute COVID-19 in children (11/175). Similarly, Dilber et al ( 82 ) reported results of Turkey, where seizures (18/382) were the most common cause of hospitalization in children with COVID-19. In addition to the incidence of seizures attracted the interest from neurologists, the management of seizures also poses a significant challenge to neurologists and caregivers.…”