Abstract
SARS-CoV-2 infection in children produces mild respiratory symptoms or no symptoms at all in most cases. Some pediatric patients develop a severe complication associated with high mortality, the multisystem inflammatory syndrome in children (MIS-C). In both scenarios, there are reports of neurological manifestations. This article aims to review the cases of pediatric patients with severe neurological issues and a coexisting positive SARS-CoV-2 test. A literature search was performed between March 2020 and May 2021. The results included the data from 41 studies, with 159 children with severe neurological manifestations, within an age range from 24 h to 17 years. The neurological disorders included 38 cases with stroke, 32 with encephalitis, 22 with encephalopathy, and 10 with Guillain–Barre syndrome. Sixty-five out of 159 cases with severe neurological manifestations were diagnosed with MIS-C. Direct neuroinvasion and the exaggerated immune response in some patients seem to be the most critical factors triggering these manifestations. Further research in the ongoing pandemic is needed to elucidate the precise mechanism.
Highlights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified inWuhan, China, in December 2019 and has become a global public health emergency [1].The Johns Hopkins University developed an online coronavirus tracker that tracks cases, deaths, and recoveries worldwide
COVID-19 usually courses with mild symptoms in children; serious complications may occur during both acute infection and the multisystem inflammatory syndrome in children (MIS-C) [55]
We aimed to review the current literature on pediatric patients with coexisting severe neurological manifestations and severe acute respiratory syndrome (SARS)-CoV-2 infections
Summary
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified inWuhan, China, in December 2019 and has become a global public health emergency [1].The Johns Hopkins University developed an online coronavirus tracker that tracks cases, deaths, and recoveries worldwide. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in. China, in December 2019 and has become a global public health emergency [1]. The Johns Hopkins University developed an online coronavirus tracker that tracks cases, deaths, and recoveries worldwide. 3,000,000 deaths in 192 countries have been reported (https://coronavirus.jhu.edu/us-map (accessed on 14 May 2021)) [2]. The disease has been devastating worldwide, causing social, health, and economic crises, the effects of which will be felt for decades to come. One of the fascinating features of SARS-CoV-2 is the broad spectrum of symptoms and complications seen in patients of all ages, races, and health statuses. In a clinical retrospective study from Wuhan, the most common symptoms of infection were fever (88.7%), cough (67.8%), myalgia, and fatigue (50%), as well as more uncharacteristic initial presenting symptoms such as anosmia and ageusia [3]
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