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Coronavirus Infections in the Nervous System of Children: A Scoping Review Making the Case for Long-Term Neurodevelopmental Surveillance - 24/03/21

Doi : 10.1016/j.pediatrneurol.2021.01.007 
Timothy G. Singer, MD, MS a, , Karen D. Evankovich, PhD b, Kristen Fisher, DO c, Gail J. Demmler-Harrison, MD d, Sarah R. Risen, MD c
a Baylor College of Medicine, Global Child Health Residency, Texas Children’s Hospital, Houston, Texas 
b Baylor College of Medicine, Department of Pediatrics, Sections of Psychology and Neurology, Texas Children’s Hospital, Houston, Texas 
c Baylor College of Medicine, Department of Pediatrics, Section of Neurology and Developmental Neuroscience, Texas Children’s Hospital, Houston, Texas 
d Baylor College of Medicine, Pediatric Infectious Disease, Texas Children’s Hospital, Houston, Texas 

Communications should be addressed to: Dr. Singer; Pediatric House Staff Office; 6621 Fannin St, West Tower 19th Floor; Houston, TX USA 77030.Pediatric House Staff Office6621 Fannin StWest Tower 19th FloorHoustonTX77030USA

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Abstract

Background

The objective of this study was to describe the case literature of human coronavirus infections in the nervous system of children, including from SARS-CoV-2, and to provide guidance to pediatric providers for managing the potential long-term effects on neurodevelopment of human coronavirus infections in the nervous system.

Methods

Using a structured strategy, the PubMed and Ovid:Embase databases were queried for articles about the clinical presentation and pathophysiology of coronavirus infections in the nervous system of children and young adults, aged 0 to 24 years.

Results

Of 2302 articles reviewed, 31 described SARS-CoV-2 infections in the nervous system of children and 21 described other human coronaviruses: HCoV-229E, HCoV-NL63, HCoV-OC43, HCoV-HKU1, MERS-CoV, SARS-CoV-1. Excepting MERS-CoV, we found cases of neurological disease in children from each human coronavirus. Children with non-SARS-CoV-2 infections have suffered acute flaccid paralysis, acute disseminated encephalomyelitis, encephalitis, and seizures. In addition, cases of ischemic, hemorrhagic, and microvascular strokes have occurred in children with SARS-CoV-2. Patients with multisystem inflammatory syndrome in children have suffered encephalitis, stroke, pseudotumor cerebri syndrome, and cytotoxic lesions of deep brain structures. Despite these reports, few articles evaluated the impact of human coronavirus infections on long-term neurodevelopmental domains including cognitive, language, academic, motor, and psychosocial outcomes.

Conclusions

Neurological manifestations of human coronavirus infections can cause severe disease in children. The case literature suggests a critical gap in knowledge of the long-term effects on child neurodevelopment of these infections. As the current SARS-CoV-2 pandemic continues, this gap must be filled to facilitate optimal outcomes in recovering children.

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Keywords : Pediatric, Coronavirus, SARS-CoV-2, Neurodevelopmental outcomes, Multisystem inflammatory syndrome in children, COVID-19, Encephalitis


Plan


 Funding: None.
 Declarations of interest: None.
 Declaration of submission: This article is only submitted to Pediatric Neurology.
 Author contributions: Drs. Singer, Fisher, and Risen conceived of the manuscript concept. All authors were involved in determining the inclusion and exclusion criteria of articles for the project. Dr. Singer conducted the search for and initial critical review of the articles. All authors were involved in the determination of which articles were included or excluded. Dr. Singer drafted the initial manuscript, helped formulate the tables, and revised the Discussion section into a unified voice. Dr. Risen critically revised the entire manuscript, helped formulate the tables, and initially drafted sections of the Discussion relating to neurological disease presentations and neurodevelopmental follow-up. Dr. Evankovich critically revised the entire manuscript and initially drafted sections of the Discussion relating to the neuropsychological sequelae of coronavirus and other nervous system infections. Dr. Demmler Harrison and Dr. Fisher critically revised the entire manuscript. All authors have read and agree to submission of the manuscript as it is written and agree to this presentation of their respective contributions to the project.


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Vol 117

P. 47-63 - avril 2021 Retour au numéro
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