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Neurological manifestations of SARS-CoV-2 infection in hospitalised children and adolescents in the UK: a prospective national cohort study
- Source :
- The Lancet. Child & Adolescent Health, LANCET CHILD & ADOLESCENT HEALTH
- Publication Year :
- 2021
-
Abstract
- Background:The spectrum of neurological and psychiatric complications associated with paediatric SARS-CoV-2 infection is poorly understood. We aimed to analyse the range and prevalence of these complications in hospitalised children and adolescents. Methods:We did a prospective national cohort study in the UK using an online network of secure rapid-response notification portals established by the CoroNerve study group. Paediatric neurologists were invited to notify any children and adolescents (age Findings:Between April 2, 2020, and Feb 1, 2021, 52 cases were identified; in England, there were 51 cases among 1334 children and adolescents hospitalised with COVID-19, giving an estimated prevalence of 3·8 (95% CI 2·9–5·0) cases per 100 paediatric patients. 22 (42%) patients were female and 30 (58%) were male; the median age was 9 years (range 1–17). 36 (69%) patients were Black or Asian, 16 (31%) were White. 27 (52%) of 52 patients were classified into the COVID-19 neurology group and 25 (48%) were classified into the PIMS-TS neurology group. In the COVID-19 neurology group, diagnoses included status epilepticus (n=7), encephalitis (n=5), Guillain-Barré syndrome (n=5), acute demyelinating syndrome (n=3), chorea (n=2), psychosis (n=2), isolated encephalopathy (n=2), and transient ischaemic attack (n=1). The PIMS-TS neurology group more often had multiple features, which included encephalopathy (n=22 [88%]), peripheral nervous system involvement (n=10 [40%]), behavioural change (n=9 [36%]), and hallucinations at presentation (n=6 [24%]). Recognised neuroimmune disorders were more common in the COVID-19 neurology group than in the PIMS-TS neurology group (13 [48%] of 27 patientsvs1 [vssix [22%] of 27 patients, p=0·0001) and received immunomodulatory treatment (22 [88%] patientsvs12 [44%] patients, p=0·045). 17 (33%) patients (10 [37%] in the COVID-19 neurology group and 7 [28%] in the PIMS-TS neurology group) were discharged with disability; one (2%) died (who had stroke, in the PIMS-TS neurology group). Interpretation:This study identified key differences between those with a primary neurological disorder versus those with PIMS-TS. Compared with patients with a primary neurological disorder, more patients with PIMS-TS needed intensive care, but outcomes were similar overall. Further studies should investigate underlying mechanisms for neurological involvement in COVID-19 and the longer-term outcomes.
- Subjects :
- Male
medicine.medical_specialty
Pediatrics
Neurology
Neurological manifestations, SARS-CoV-2 infection, hospitalised, children, adolescents
Encephalopathy
Neurological disorder
State Medicine
Cohort Studies
Intensive care
Developmental and Educational Psychology
medicine
Humans
Prospective Studies
Child
Prospective cohort study
business.industry
Mental Disorders
COVID-19
Chorea
Articles
medicine.disease
Patient Discharge
United Kingdom
Hospitalization
Pediatrics, Perinatology and Child Health
Female
Nervous System Diseases
medicine.symptom
business
Child, Hospitalized
Encephalitis
Cohort study
Subjects
Details
- Language :
- English
- ISSN :
- 23524642
- Database :
- OpenAIRE
- Journal :
- The Lancet. Child & Adolescent Health, LANCET CHILD & ADOLESCENT HEALTH
- Accession number :
- edsair.doi.dedup.....61c678301e22dab3f28d3c380bca0515