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Copyright of Turkish Journal of Neurology / Turk Noroloji Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Neurological manifestations of SARS-CoV-2 infection have been reported from many countries around the world, including the South Asian region. This surveillance study aimed to describe the spectrum of neurological disorders associated with COVID-19 in Sri Lanka. Methods: COVID-19 patients manifesting neurological disorders one week prior and up to six weeks after infection were recruited from all the neurology centres of the government hospitals in Sri Lanka from May 2021 – May 2022. Data was collected using a structured data form that was electronically transmitted to a central repository. All patients were evaluated and managed by a neurologist. Data were analysed using simple descriptive analysis to characterise demographic and disease related variables, and simple comparisons and logistic regression were performed to analyse outcomes and their associations. Results: One hundred and eighty-four patients with neurological manifestations associated with COVID-19 were recruited from all nine provinces in Sri Lanka. Ischaemic stroke (31%) was the commonest neurological manifestation followed by encephalopathy (13.6%), Guillain–Barre syndrome (GBS) (9.2%) and encephalitis (7.6%). Ischaemic stroke, encephalitis and encephalopathy presented within 6 days of onset of COVID-19 symptoms, whereas GBS and myelitis presented up to 10 days post onset while epilepsy and Bell palsy presented up to 20 – 40 days post onset. Haemorrhagic stroke presented either just prior to or at onset, or 10 – 25 days post onset of COVID-19 symptomatic infection. An increased frequency of children presenting with encephalitis and encephalopathy was observed during the Omicron variant predominant period. A poor outcome (no recovery or death) was associated with supplemental oxygen requirement during admission (Odds Ratio: 12.94; p = 0.046). Conclusions: The spectrum and frequencies of COVID-19 associated neurological disorders in Sri Lanka were similar to that reported from other countries, with strokes and encephalopathy being the commonest. Requiring supplemental oxygen during hospitalisation was associated with a poor outcome. [ABSTRACT FROM AUTHOR]

Immunotherapy is an important treatment modality for several pediatric neurology conditions. The immunosuppressive therapies may predispose to a heightened risk of infection and fatal consequences. The paper aims to examine the immunological effects of various commonly used immunomodulators and their associated risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. Immunotherapies may exhibit different effects at the different stages of coronavirus disease 19 (COVID-19) pathogenesis. Conventional immunosuppressive therapies appear to produce less favorable results or may aggravate the risk of infection, especially during the primary response phase. Whereas immunomodulators such as inhibitors of pro-inflammatory cytokines, antagonists of complement activity, and those drugs which decrease viral-neutralizing antibodies levels seem to have beneficial effects during the secondary hyper inflammation phase of infection. However, adequate clinical data is yet to be available for most of the immunotherapies. Based on the emerging evidence, the authors attempt to draw some conclusions of practical importance on the applications of different immunomodulators for children with pediatric neurological disorders in the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]