Pediatric Neuroinflammatory Disease in the Era of COVID-19: Single Center Survey of the Medical and Social Impact of COVID-19 and COVID-19 Vaccines (S34.006)

Abstract

<h3>Objective:</h3> We explore the impact of COVID-19 in pediatric patients with neuroinflammatory disorders and describe parent/guardian vaccination concerns and self-reported side effects of the COVID-19 vaccination. <h3>Background:</h3> Neurological manifestations of COVID-19 in children range from mild to severe. There is limited data surrounding COVID-19 and the COVID-19 vaccine in pediatric populations with known neuroinflammatory disorders. <h3>Design/Methods:</h3> A survey was distributed to guardians of 68 children enrolled in a single center neuroimmunology registry. Clinical data was obtained from the registry. <h3>Results:</h3> 26 (38%) responded to the survey (62% female). Diagnoses included multiple sclerosis (5, 19%), myelin oligodendrocyte glycoprotein antibody-associated disease (8, 31%), acute disseminated encephalomyelitis (1, 4%), autoimmune encephalitis (1, 14%), and other (16, 57%). 10 (38%) had a confirmed COVID-19 diagnosis, and 3 were classified as probable COVID-19 cases based on CDC clinical and exposure criteria. Neurological symptoms in the 6-weeks after confirmed or probable COVID-19 infections were: behavioral changes (4, 31%), paresthesias (1, 8%), taste changes (3, 23%) vision changes (2, 15%) urinary retention (1, 8%), and gait abnormalities (1, 8%). 12 (46%) received at least one COVID-19 vaccine dose. For unvaccinated children, 50% of respondents were “not at all willing” to vaccinate and lack of knowledge of long-term side effects was the most common reason. Neurological side effects in the 6-weeks following the vaccination included: behavioral changes (2, 17%), parasthesias (1, 8%), and gait abnormalities (1, 8%). Of children with confirmed or probable COVID-19 or who received a COVID-19 vaccine, none experienced neurological disease flares requiring treatment alterations or hospitalization. <h3>Conclusions:</h3> Half of children with a neuroinflammatory disease had confirmed or probable COVID-19 and less than half were vaccinated against COVID-19. Children with COVID-19 or who received the COVID-19 vaccine did not have disease flares requiring change in immunotherapy or hospitalization. Guardians are concerned about long term side effects of COVID-19 vaccines. <b>Disclosure:</b> Ms. Bahri has nothing to disclose. Ms. Hurst has nothing to disclose. Ms. Alexander has nothing to disclose. Dr. Hutchinson has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Katz, Korin, Cunningham Attorneys At Law.