Neuromuscular complications of severe COVID-19 in paediatric patients: Medium-term follow-up

Abstract

Neuromuscular complications in paediatric patients with severe coronavirus disease 2019 (COVID-19) are poorly characterised. However, adult patients with severe COVID-19 reportedly present with frequent neuromuscular complications that mainly include critical illness polyneuropathy (CIP), critical illness myopathy (CIM), and focal neuropathies. We examined the records of all paediatric patients with severe COVID-19 who were mechanically ventilated and experienced neuromuscular complications from our single tertiary centre between March 2020 and August 2021. During this period, 4/36 (11%) patients admitted to the paediatric ICU who were mechanically ventilated experienced neuromuscular complications (one CIM, two focal neuropathies, and one CIP associated with plexopathy). In three of them, the gamma genetic variant of SARS-CoV-2 was identified. At the 4-5 month follow-up, three of our patients exhibited slight clinical improvement. We conclude that paediatric patients with severe COVID-19 may present neuromuscular complications similar to adults (11%), and their medium-term prognosis seems unfavourable.

Keywords: Brachial plexus neuropathies; COVID-19; Intensive care units; Neuromuscular manifestations; Peripheral nervous system; Severe acute respiratory syndrome.

Fig. 1

Selection flowchart of 36 paediatric patients with severe COVID-19 Thirty-six patients were hospitalized in the ICU. Six of them had sensitive or motor deficits, but only four of them had motor and EMG findings, which were confirmatory of a neuromuscular complication. ICU: intensive care unit, MV: mechanical ventilation.