Spectrum of Neurological Manifestations in Pediatric Patients with Multisystem Inflammatory Syndrome in Children (MIS-C) Linked to COVID-19 (preprint)

ABSTRACT

Background Since December 2019, Covid-19 has resulted in high morbidity and mortality worldwide. MIS-C associated with SARS-CoV-2 infection led to serious and life-threatening illness in children causing severe multisystem inflammation. It presented with new neurological symptoms involving both the central and peripheral nervous systems. The aim is to evaluate the neurological manifestations in pediatric patients with MIS-C associated to COVID-19.Aim To evaluate the neurological manifestations in Pediatric Patients with Multisystem Inflammatory Syndrome in Children (MIS-C) associated to COVID-19.Methods This cross section study included patients who were admitted to Pediatric Intensive Care Unit (PICU) isolation unit at Minia University Hospital during the period from December 2020 to April 2022. The study included a total of 303 patients who were classified in to 3 groups; Group (I) (MIS-C, PCR positive), Group (II) (MIS-C, PCR negative), and Group (III) (Non-MIS-C, PCR positive).Results The respiratory, cardiovascular, hematologic and gastrointestinal symptoms were significantly greater among Group (II). Convulsions, DCL, Headache, and Weakness were significantly more demonstrated in Group (I) (19 (31.7%), 17 (28.3%), 17 (28.3%), and 15 (25.0%), respectively). While, drowsiness was significantly more demonstrated in Group (II) (41 (21.9%)). Lymphocytes (%) showed significant lower values in Group (I) and Group (II) (Mean ± SD is 18.9 ± 1.8(, compared to Group (III) (Mean ± SD is 21.4 ± 1.8), p-value < 0.01. D-dimer, CRP and S. Ferritin levels were significantly increased among Group (I) while albumin levels were significantly decreased in Group (I). Troponin levels were significantly increased in patients of Group (II). The majority of patients in the three studied groups showed abnormal Chest CT findings in the form of ground glass opacities (CO-RADS III). The percentage of non-survived patients was significantly increased in Group (I).Conclusion Pediatric patients with MIS-C and associated to COVID-19 presenting with neurological, respiratory, cardiovascular, gastrointestinal, and hematologic symptoms. The neurological manifestations could include convulsions, DCL, headache, and weakness.