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

• Main Authors: Antonella Riva (Author), Gianluca Piccolo (Author), Federica Balletti (Author), Maria Binelli (Author), Noemi Brolatti (Author), Alberto Verrotti (Author), Elisabetta Amadori (Author), Alberto Spalice (Author), Thea Giacomini (Author), Maria Margherita Mancardi (Author), Paola Iannetti (Author), Maria Stella Vari (Author), Emanuela Piccotti (Author), Pasquale Striano (Author), Giacomo Brisca (Author)
• Format: Book
• Published: Frontiers Media S.A., 2022-07-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

BackgroundIn the pediatric population, the knowledge of the acute presentation of SARS-CoV-2 infection is mainly limited to small series and case reports, particularly when dealing with neurological symptoms. We describe a large cohort of children with acute SARS-CoV-2 infection, focusing on the neurological manifestations and investigating correlations between disease severity and population demographics.MethodsPatients aged 0-18 years with a positive molecular swab were recruited between April 2020 and March 2021 from a tertiary Italian pediatric centre. Clinical data, imaging, and laboratory test results were retrieved from our local dataset and statistically analyzed.ResultsA total of 237 patients with a median age of 3.2 years were eligible; thirty-two (13.5%) presented with neurological symptoms, including headache (65.6%), altered awareness (18.8%), ageusia/anosmia (12.5%), seizures (6.3%), and vertigo (6.3%), combined in 7 (21.9%) cases. Respiratory (59.5%) and gastrointestinal (25.3%) symptoms were the most common among the 205 (86.5%) patients without neurological involvement. Neurological symptoms did not significantly influence the severity of the triage access codes. Moreover, pre-existing medical conditions were not higher in the group with neurological manifestations. Overall, fifty-nine patients (25%, 14/59 with neurological symptoms) required treatment, being antibiotics, systemic steroids, and heparin those most prescribed.ConclusionOur study supports the overall benign course of the SARS-CoV-2 infection in children. Neurological manifestations, except for headache, remain a rare presenting symptom, and disease severity seems unrelated to pre-existing medical conditions.

Item Description

2296-2360
10.3389/fped.2022.909849