Range Of COVID-19 Neurological Complications Seen In Kids: S
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Children may develop neurological complications of COVID-19 ranging from mild to severe, a large brain-imaging study confirms. The study included 38 children with encephalopathy from eight countries with SARS-CoV-2 infection and abnormal neuroimaging findings on magnetic resonance imaging or computed tomography.

Clinical history and associated plasma and cerebrospinal fluid data were reviewed by a central neuroradiology panel, a child neurologist, and a paediatric infectious diseases expert. The children were categorised on the basis of their time of probable exposure to SARS-CoV-2.

In addition, cases were excluded when a direct link to SARS-CoV-2 infection could not be established or an established alternate diagnostic cause could be hypothesised. The imaging data were remotely reviewed by a central panel of five paediatric neuroradiologists and a consensus opinion obtained on the imaging findings.

Recurring patterns of disease were identified, with neuroimaging abnormalities ranging from mild to severe. The most common imaging patterns were postinfectious immune-mediated acute disseminated encephalomyelitis-like changes of the brain, myelitis and neural enhancement.

Cranial nerve enhancement could occur in the absence of corresponding neurological symptoms. Splenial lesions and myositis were predominantly observed in children with multisystem inflammatory syndrome.Cerebrovascular complications in children were less common than in adults. Fatal atypical CNS co-infections developed in four previously healthy children infected with SARS-CoV-2.

The researchers concluded that acute-phase and delayed-phase SARS-CoV-2-related CNS abnormalities are seen in children. Recurring patterns of disease and atypical neuroimaging manifestations can be found and should be recognised being as potentially due to SARS-CoV-2 infection as an underlying aetiological factor.