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Meta-Analysis
. 2021 Jul 2;67(3):fmaa070.
doi: 10.1093/tropej/fmaa070.

Neurological Complications of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-Analysis

Affiliations
Meta-Analysis

Neurological Complications of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-Analysis

Prateek Kumar Panda et al. J Trop Pediatr. .

Abstract

Background: Knowledge about neurological complications of COVID-19 in children is limited due to the paucity of data in the existing literature. Some systematic reviews are available describing overall clinical features of COVID-19 in children and neurological complications of COVID-19 in adults. But to the best of our knowledge, no systematic review has been performed to determine neurological manifestations of COVID-19.

Methods: Six different electronic databases (MEDLINE, EMBASE, Web of Science, CENTRAL, medRxiv and bioRxiv) were searched for articles related to COVID-19 and neurological complications in children. Studies/case series reporting neurological manifestations of COVID-19 in patients aged ≤18 years, as well as case reports, as neurological complications appear to be rare. The pooled estimate of various non-specific and specific neurological manifestations was performed using a random effect meta-analysis.

Results: Twenty-one studies/case series and five case reports (3707 patients) fulfilled the eligibility criteria and were included in this systematic review, from a total of 460 records. Headache, myalgia and fatigue were predominant non-specific neurological manifestations, presenting altogether in 16.7% cases. Total of 42 children (1%) were found to have been reported with definite neurological complications, more in those suffering from a severe illness (encephalopathy-25, seizure-12, meningeal signs-17). Rare neurological complications were intracranial hemorrhage, cranial nerve palsy, Guillain-Barré syndrome and vision problems. All children with acute symptomatic seizures survived suggesting a favorable short-term prognosis.

Conclusion: Neurological complications are rare in children suffering from COVID-19. Still, these children are at risk of developing seizures and encephalopathy, more in those suffering from severe illness.

Keywords: COVID-19; children; encephalopathy; neurological symptoms; seizures.

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Figures

Fig. 1.
Fig. 1.
Flow diagram of the study selection process.

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