ABSTRACT
Coronavirus disease 2019 (COVID-19) usually leads to a mild infectious disease course in children, but serious complications may occur in conjunction with both acute infection and associated phenomena such as the multisystem inflammatory syndrome in children (MIS-C). Neurological symptoms, which have been predominantly reported in adults, range from mild headache to seizure, peripheral neuropathy, stroke, demyelinating disorders, and encephalopathy. Similar to respiratory and cardiac manifestations of COVID-19, neurological complications present differently based on age and underlying comorbidities. This review provides a concise overview of the neurological conditions seen in the context of COVID-19, as well as potential mechanisms and long-term implications of COVID-19 in the pediatric population from literature reviews and primary data collected at NewYork-Presbyterian Morgan Stanley Children's Hospital.
Subject(s)
COVID-19/complications , Nervous System Diseases/virology , Child , Child, Preschool , Female , Humans , Male , SARS-CoV-2Subject(s)
Abducens Nerve Diseases/etiology , COVID-19/complications , Diplopia/etiology , Intracranial Hypertension/etiology , SARS-CoV-2/immunology , Systemic Inflammatory Response Syndrome/physiopathology , Abdominal Pain/etiology , Antibodies, Viral/blood , COVID-19/diagnosis , COVID-19/physiopathology , COVID-19 Nucleic Acid Testing , COVID-19 Serological Testing , Cerebrospinal Fluid/virology , Child , Delayed Diagnosis , False Negative Reactions , Headache/etiology , Humans , Intracranial Hypertension/cerebrospinal fluid , Intracranial Hypertension/physiopathology , Nasopharynx/virology , Papilledema/etiology , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2/isolation & purification , Systemic Inflammatory Response Syndrome/complicationsABSTRACT
The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread quickly across the globe, creating unique and pressing challenges for today's physicians. Although this virus disproportionately affects adults, initial SARS-CoV-2 infection can present a significant disease burden for the pediatric population. A review of the literature yields descriptive studies in pediatric patients; however, no evidence-based or evidence-informed guidelines for the diagnosis and treatment of the hospitalized pediatric patient have been published in peer-reviewed journals. The authors, working at a quaternary care children's hospital in the national epicenter of the SARS-CoV-2 pandemic, found an urgent need to create a unified, multidisciplinary, evidence-informed set of guidelines for the diagnosis and management of coronavirus disease 2019 in children. In this article, the authors describe our institutional practices for the hospitalized pediatric patient with confirmed or suspected initial SARS-CoV-2 infection. The authors anticipate that developing evidence-informed and institution-specific guidelines will lead to improvements in care quality, efficiency, and consistency; minimization of staff risk of exposure to SARS-CoV-2; and increased provider comfort in caring for pediatric patients with SARS-CoV-2 infection.