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. 2021 Sep 18;47(1):191.
doi: 10.1186/s13052-021-01144-y.

Are we sure that the neurological impact of COVID 19 in childhood has not been underestimated?

Nicola Principi  1 , Susanna Esposito  2
Affiliations

Are we sure that the neurological impact of COVID 19 in childhood has not been underestimated?

Nicola Principi et al. Ital J Pediatr. .

Abstract

Background: Presently, it is known that, even if less frequently than in adults, children can develop a severe new coronavirus disease 2019 (COVID-19). Children with the SARS-CoV-2 infection can have neurological signs and symptoms of disease more frequently than previously thought, revealing the involvement of the central nervous system, the peripheral nervous system, or both. Aim of this manuscript is to highlight the neurologic complications associated with SARS-CoV-2 among pediatric patients with COVID-19, suggesting when to monitor carefully neurologic development.

Main findings: Children with a severe chronic underlying disease, infants and toddlers and those who develop the so-called multisystem inflammatory syndrome (MIS-C) are those with the highest incidence of neurological complications. Fortunately, in most of the cases, neurological manifestations, mainly represented by headache and anosmia, are mild and transient and do not significantly complicate the COVID-19 course. However, in some cases, very severe clinical problems associated with relevant alterations of neuroimaging, electroencephalography, nerve conduction studies and electromyography findings can develop. Generally, almost all the children with COVID-19 and neurological manifestations till now described have made a complete recovery, although in some cases this has occurred after several weeks of treatment. Moreover, COVID-19 infection during pregnancy has been found associated with an increased risk of obstetric complications that can lead to neurological acute and long-term manifestations in neonates.

Conclusions: Based on data showing the neurologic impact of COVID-19 in pediatric age, we suggest monitoring neurological development a few months after healing in pediatric patients who have presented MIS-C, seizures or other neurological manifestations and in children of pregnant women with COVID-19 in order to detect overt and subtle deficits.

Keywords: ADEM; COVID-19; Children; MIS-C; Neurologic complications.

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Conflict of interest statement

The authors declare no competing interest.

References

    1. Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, Tong S. Epidemiology of COVID-19 among children in China. Pediatrics. 2020;145(6):e20200702. doi: 10.1542/peds.2020-0702. - DOI - PubMed
    1. Vergine G, Fantini M, Marchetti F, Stella M, Valletta E, Biasucci G, Lanari M, Dodi I, Bigi M, Magista AM, Vaienti F, Cella A, Affanni P, Re MC, Sambri V. Esposito S; Regione Emilia-Romagna COVID-19 Pediatric Working Group (RERCOPed). Home Management of Children With COVID-19 in the Emilia-Romagna Region, Italy. Front Pediatr. 2020;8:575290. doi: 10.3389/fped.2020.575290. - DOI - PMC - PubMed
    1. Esposito S, Marchetti F, Lanari M, Caramelli F, De Fanti A, Vergine G, Iughetti L, Fornaro M, Suppiej A, Zona S, Pession A, Biasucci G. Working group on COVID-19 in pediatrics of the Emilia-Romagna region (RE-CO-Ped). COVID-19 Management in the Pediatric age: consensus document of the COVID-19 working Group in Paediatrics of the Emilia-Romagna region (RE-CO-Ped), Italy. Int J Environ Res Public Health. 2021;18(8):3919. doi: 10.3390/ijerph18083919. - DOI - PMC - PubMed
    1. Götzinger F, Santiago-García B, Noguera-Julián A, Lanaspa M, Lancella L, Calò Carducci FI, Gabrovska N, Velizarova S, Prunk P, Osterman V, Krivec U, Lo Vecchio A, Shingadia D, Soriano-Arandes A, Melendo S, Lanari M, Pierantoni L, Wagner N, L'Huillier AG, Heininger U, Ritz N, Bandi S, Krajcar N, Roglić S, Santos M, Christiaens C, Creuven M, Buonsenso D, Welch SB, Bogyi M, Brinkmann F, Tebruegge M, Pfefferle J, Zacharasiewicz A, Berger A, Berger R, Strenger V, Kohlfürst DS, Zschocke A, Bernar B, Simma B, Haberlandt E, Thir C, Biebl A, vanden Driessche K, Boiy T, van Brusselen D, Bael A, Debulpaep S, Schelstraete P, Pavic I, Nygaard U, Glenthoej JP, Heilmann Jensen L, Lind I, Tistsenko M, Uustalu Ü, Buchtala L, Thee S, Kobbe R, Rau C, Schwerk N, Barker M, Tsolia M, Eleftheriou I, Gavin P, Kozdoba O, Zsigmond B, Valentini P, Ivaškeviciene I, Ivaškevicius R, Vilc V, Schölvinck E, Rojahn A, Smyrnaios A, Klingenberg C, Carvalho I, Ribeiro A, Starshinova A, Solovic I, Falcón L, Neth O, Minguell L, Bustillo M, Gutiérrez-Sánchez AM, Guarch Ibáñez B, Ripoll F, Soto B, Kötz K, Zimmermann P, Schmid H, Zucol F, Niederer A, Buettcher M, Cetin BS, Bilogortseva O, Chechenyeva V, Demirjian A, Shackley F, McFetridge L, Speirs L, Doherty C, Jones L, McMaster P, Murray C, Child F, Beuvink Y, Makwana N, Whittaker E, Williams A, Fidler K, Bernatoniene J, Song R, Oliver Z, Riordan A. COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study. Lancet Child Adolesc Health. 2020;4(9):653–661. doi: 10.1016/S2352-4642(20)30177-2. - DOI - PMC - PubMed
    1. Esposito S, Caramelli F, Principi N. What are the risk factors for admission to the pediatric intensive unit among pediatric patients with COVID-19? Ital J Pediatr. 2021;47(1):103. doi: 10.1186/s13052-021-01057-w. - DOI - PMC - PubMed

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