Nihal Akçay (Turkey)
Bakirkoy Dr Sadi Konuk Research and Training Hospital Pediatric Intensive Care UnitAuthor Of 1 Presentation
ENCEPHALITIS ASSOCIATED WITH SARS COV-2 INFECTION IN CHILDREN: A CASE SERIES
Abstract
Background and Aims
Coronavirus Disease 2019 (COVID-19) can cause nonpsesific neurologic sypmtoms in children such as headache, altered mental state and seizures. Direct viral invasion of the central nervous system and neuroinflammatory injury have been accused as the underlying causes of neurologic manifestations. Here we present a case series of 3 patients admitted to our pediatric intensive care unit with status epilepticus and associated later with COVID-19.
Methods
A 12 year-old male (Patient 1), 3 years old female (Patient 2) and 7 years old male (Patient 3) patients were admitted with status epilepticus. Patient 1 consulted with distribution of conscioussness and seizures, had SARS CoV-2 contact history. Patient 2 was brought to our emergency department with cardiac arrest followed by status epilepticus. She was positive for SARS CoV-2 on nasopharyngeal swab 3 months ago and had begun having seizures for two weeks. Patient 3 had hyperactivity disorder and consulted with behavioral changes and seizures. He did not have SARS CoV-2 contact history.
Results
All patients had lympopenia on admission. C-reactive protein, procalcitonin, ferritin and Pro-Brain natriuretic peptide levels were in normal ranges. D-dimer was increased in Patients 1 and 2 (7.99, 3.26µgFEU/mL, respectively). They were negative on nasopahyngeal swab for SARS CoV-2 however, Anti-SARS-CoV-2 Ig M and G were detected in their serums. Cerebrospinal Fluid work up showed high protein levels with no cell on microscopy. The patients were diagnosed with encephalitis associated with SARS CoV-2 Infection.
Conclusions
COVID-19 can cause neurologic manifestations in children and should be kept in mind especially when contact history exits.