Back to Search Start Over

Neurological manifestations of SARS-CoV-2 infection in hospitalised children and adolescents in the UK: a prospective national cohort study

Authors :
Stephen T J Ray
Omar Abdel-Mannan
Mario Sa
Charlotte Fuller
Greta K Wood
Karen Pysden
Michael Yoong
Helen McCullagh
David Scott
Martin McMahon
Naomi Thomas
Micheal Taylor
Marjorie Illingworth
Nadine McCrea
Victoria Davies
William Whitehouse
Sameer Zuberi
Keira Guthrie
Evangeline Wassmer
Nikit Shah
Mark R Baker
Sangeeta Tiwary
Hui Jeen Tan
Uma Varma
Dipak Ram
Shivaram Avula
Noelle Enright
Jane Hassell
Amy L Ross Russell
Ram Kumar
Rachel E Mulholland
Sarah Pett
Ian Galea
Rhys H Thomas
Laura A Benjamin
Ming Lim
Yael Hacohen
Tom Solomon
Michael J Griffiths
Benedict D Michael
Rachel Kneen
Gerome Breen
Hannah Castell
Ceryce Collie
Lilly George
Monika Hartmann
Marc Henrion
Maria Kinali
Christina Petropoulos
Sithara Ramdas
Victoria Vlachou
Brigitte Vollmer
Bethany Facer
Cordelia Dunai
Laura Benjamin
group, CoroNerve 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.

Details

Language :
English
ISSN :
23524642
Database :
OpenAIRE
Journal :
The Lancet. Child & Adolescent Health, LANCET CHILD & ADOLESCENT HEALTH
Accession number :
edsair.doi.dedup.....61c678301e22dab3f28d3c380bca0515