Examine highlights neurological influence of COVID-19 on youngsters

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A small number of previously healthy children infected with COVID-19 can have severe neurological complications, according to research by researchers at the University of Manchester.

A study published in Lancet Child and Adolescent Health found that 38 children from eight countries had brain and / or spinal cord abnormalities.

The children, who all had MRIs, showed symptoms such as fever, impaired consciousness, problems moving arms and legs, and cognitive dysfunction.

Most of the children (32) had either recovered (26) or were on their way to recovery (6). Eight did not show the respiratory symptoms commonly seen in patients with the virus. Four died from co-infections like TB and MRSA after COVID-19 made them more vulnerable. Two of the children were paralyzed after the virus hit their spinal cord.

Funded by the American Society of Pediatric Neuroradiology, it is the largest study in children whose central nervous system is either directly or indirectly affected by COVID-19.

Although the study is unable to identify the incidence of neurological problems in children with the virus, the team expects low numbers. Professor Stavros Stivaros, Pediatric Neuroradiologist and Director of Imaging at the University of Manchester, was the joint lead author on the study. He said, "From the number of children we have seen with COVID-19, it appears that neurological complications are rare. However, it is important to recognize that COVID-19 could be a possible diagnosis even if these children are not Exhibiting viruses We hope that our study will alert hospital doctors and A&E workers who care for children that COVID-19 should be viewed as one of the factors that can cause this brain and spinal cord dysfunction. We've known for a long time Various viruses can affect the brain and spine, but until this study we couldn't really say for sure that COVID-19, although rare, could have that effect too. "

Of the 38 children with COVID-19 scanned, a group of 12 suffered from breathing problems caused by the virus, with four of those children dying from co-infection. One stayed on a ventilator six months after her presentation due to a spinal injury.

In a second group, eight children had neurological problems, but did not show any of the classic symptoms of COVID-19 such as difficulty breathing or loss of taste or smell. Unfortunately, one of these children remains stationary on a ventilator for six months after the presentation.

In a third group, 11 children developed a delayed inflammatory response to COVID known as multi-system inflammatory syndrome. In a final fourth group, seven children had neurological symptoms and abnormal brain and spine imaging, but could not be divided into the other three groups.

Professor Stivaros said, "It is important to emphasize that most children with COVID-related neurological disorders get better, but still rarely occur in previously healthy children. A small number of these previously healthy children either die directly from COVID-19 or from their increased sensitivity to other infections may cause some neurological complications due to a delayed response to their COVID-19 infection. We also suspect that children who were neurologically impaired by COVID-19 earlier in the pandemic may not have been explained by the lack of available PCR testing or because the atypical or delayed symptoms shown by children were not immediately identified as COVID-19 related. "

Of the 111 respondents to the American Society of Pediatric Neuroradiology's international call for COVID-19 cases, 80 cases were submitted for review, with 42 either excluded or withdrawn and 38 children reported in the study. And of the 38 children with neurological diseases related to SARS-CoV-2 infection, 13 came from France, eight from Great Britain, five from the USA, four from Brazil, four from Argentina, two from India, one from Peru and one from Peru Saudi Arabia.

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More information:
Camilla E. Lindan et al. Neuroimaging Manifestations in Children with SARS-CoV-2 Infection: A Multinational, Multicenter, Collaborative Study, The Lancet Child & Adolescent Health (2020). DOI: 10.1016 / S2352-4642 (20) 30362-X

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University of Manchester

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