Abstract
PurposeSeveral weeks after COVID-19 infection, some children report the persistence or recurrence of functional complaints. This clinical presentation has been referred as “long COVID” in the adult population, and an [18F]-FDG brain PET hypometabolic pattern has recently been suggested as a biomarker. Herein, we present a retrospective analysis of 7 paediatric patients with suspected long COVID who were explored by [18F]-FDG brain PET exam. Metabolic brain findings were confronted to those obtained in adult patients with long COVID, in comparison to their respective age-matched control groups.MethodsReview of clinical examination and whole-brain voxel-based analysis of [18F]-FDG PET metabolism of the 7 children in comparison to 21 paediatric controls, 35 adult patients with long COVID and 44 healthy adult subjects.ResultsDespite lower initial severity at the acute stage of the infection, paediatric patients demonstrated on average 5 months later a similar brain hypometabolic pattern as that found in adult long COVID patients, involving bilateral medial temporal lobes, brainstem and cerebellum (p-voxel < 0.001, p-cluster < 0.05 FWE-corrected), and also the right olfactory gyrus after small volume correction (p-voxel = 0.010 FWE-corrected), with partial PET recovery in two children at follow-up.ConclusionThese results provide arguments in favour of possible long COVID in children, with a similar functional brain involvement to those found in adults, regardless of age and initial severity.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00259-021-05528-4.
Highlights
Neurological manifestations of COVID-19 have been largely described [1, 2]
We previously identified a brain PET hypometabolism in adult patients with long COVID, involving the olfactory bulb, and the brain network connected to this region, in particular the limbic temporal lobe, the brainstem and the cerebellum [15,16,17]
This case series presents 7 children with persistent functional complaints after proven or suspected SARS-CoV-2 infection from a single centre with evidence of a PET hypometabolism pattern similar to that previously found in adults with long COVID, involving the olfactory gyrus and medial temporal lobes extending to the pons and cerebellum [16]
Summary
Neurological manifestations of COVID-19 have been largely described [1, 2]. In addition to those subjects usually identified by conventional explorations, others report persistent orThis article is part of the Topical Collection on Neurology1 3 Vol.:(0123456789)European Journal of Nuclear Medicine and Molecular ImagingWhile long COVID is currently being recognized by the medical community [4, 5, 8,9,10], the paediatric forms are still debated. If long COVID mostly affects younger patients with few initial symptoms [16], the occurrence of such presentations in paediatric patients should be investigated. Such presentations could have significant healthcare and social implications, especially because children are exposed to the virus and constitute a significant portion of the unvaccinated population. In this line, two published case series from Sweden and Latvia first described long COVID in few children [18, 19]. In a study from the UK [22], 4.4% of 1,734 children who were positively tested for SARS-CoV2 experienced illness duration ≥ 28 days
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