Stephen Ray (United Kingdom)
University of Liverpool Clinical Infection, Microbiology and ImmunologyPresenter of 1 Presentation
NEUROLOGICAL MANIFESTATIONS OF COVID-19 INFECTION IN CHILDREN: RESULTS OF A NATIONAL BRITISH SURVEILLANCE STUDY (ID 1182)
Abstract
Background
Neurological complications associated with COVID-19 are reported in adults. We undertook an observational study to examine the neurological manifestations of COVID-19 infection in children across the United Kingdom
Methods
The CoroNerve Study Group (www.coronerve.com) developed an online network of secure rapid-response notification portals via major UK neuroscience & psychiatry bodies. Cases were included if they met the case definitions and reported prospectively onto a standardised online case report form.
Results
Fifty two cases were included: 25 (48%) had PIMS-TS; the remaining 27 (52%) were termed the COVID neurology group. The median age was 9 years (range 1-17); the majority were non-caucasian [36 (69%)]. In the COVID neurology group, 14 had encephalopathy: 6 encephalitis (4 ADEM, 2 encephalitis), 7 status epilepticus and 1 encephalopathy; 5 had Guillain-Barré syndrome, three demyelinating disorders; two acute psychosis, two chorea, one TIA. The PIMS-TS group had overlapping neurological manifestations including 21 (84%) with encephalopathy [two strokes] and nine (36%) with peripheral nervous system involvement (table 1).
Twenty-eight had CSF analysis; 8 (29%) had a pleocytosis (median 20 white cell count/mm, range 6-6075). All had negative molecular screening (including 3 tested for SARS-CoV-2). Central nervous system imaging was abnormal in 24/46 (52%). Patients in the PIMS-TS group were more likely to be admitted to ICU [20/25 (80%) vs 8/27 (30%)] and require immunomodulation [22/25 (88%) vs 6/27 (22%)]. Thirty-five children (67%) had apparent full recovery (Modified Rankin Score 0-1) and one child (2%) died (PIMS-TS stroke).
Conclusions
Neurological manifestations associated with COVID-19 infection in children are uncommon but include a wide spectrum of phenotypes (often overlapping in PIMS-TS). Stroke and psychiatric presentations are less common than in adults and short-term outcome appears good.
Clinical Trial Registration
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