Some children with COVID-related syndrome develop neurological symptoms

Reports on mysterious inflammatory syndrome linked to COVID that afflicts some children and adolescents have mainly focused physical symptoms: itching, abdominal pain, red eyes and, in more severe cases, heart problems such as low blood pressure, heart attacks, and difficulty pumping blood.

Now, new research shows that a significant number of young people with the syndrome also develop neurological symptoms, including hallucinations, confusion, difficulty speaking, and problems with balance and coordination. the study of 46 children who were treated in a London hospital found that just over half (24) had these neurological symptoms, which they had never experienced before.

Compared to patients without neurological symptoms, those who presented with them needed respirators in an approximate two-to-one ratio because they were “very ill with systemic shock as part of their hyperinflammatory state,” commented one. of the study’s authors, Omar Abdel-Mannan. , clinical researcher at the Institute of Neurology at University College London. Patients with neurological symptoms needed drugs to improve the heart’s ability to contract in roughly the same amount, the experts noted.

The condition, called pediatric multi-system inflammatory syndrome (MIS-C), usually appears two to six weeks after a COVID infection, but it often produces only mild symptoms or no symptoms. The syndrome is rare, but it can be very serious. According to the latest data from the Centers for Disease Control and Prevention, there have been 3,165 cases in 48 states, Puerto Rico and the District of Columbia, including 36 deaths.

The new findings support the theory that the syndrome is linked to a sudden increase in inflammation caused by an immune response to the virus, Abdel-Mannan said. For the children included in the research, the neurological symptoms mostly resolved when the physical symptoms were treated.

Recently, some doctors in the United States have also reported neurological symptoms in children with MIS-C. In a study published last month in JAMA Neurology, of 616 young people who were admitted to 61 hospitals with the syndrome last year, 126 had neurological problems, 20 of which developed what researchers described as “problems”. potentially fatal ”. or “severe encephalopathy”.

This new report, presented as preliminary research on Tuesday at an annual meeting of the American Academy of Neurology, assessed children under 18 with the syndrome (it has a different name and acronym in the UK, PIMS- TS). Who were admitted between April and September of last year at Great Ormond Street Hospital (GOSH, for its acronym in English). The data is also included in a prepublication of a larger study that has not yet been peer reviewed.

As with other studies of the syndrome, including those conducted in the United States, the researchers mentioned that the majority of people with the disease were “non-white,” a pattern that public health experts say. , reflects how the pandemic has affected communities of color. Almost two-thirds of the patients were men and the average age was 10 years.

The 24 patients with neurological symptoms had headaches and 14 suffered from encephalopathy, a general term that can include confusion, problems with memory or attention, and other types of impaired mental function. Six of the children had hallucinations, such as “describing people in the room who were not there or seeing cartoons or animals moving on the walls,” said Abdel-Mannan, adding that some had hallucinated auditory in which they “heard voices of were not present”.

Six of the children suffered from weakness or difficulty controlling the muscles used to speak. Four had problems with balance or coordination. One child suffered from seizures and three children suffered from peripheral nerve abnormalities, including weakness in the muscles of the face and shoulders. Peripheral nerve damage in one patient caused a problem with dropping foot for which he needed crutches and a recommendation for a nerve transplant, said Abdel-Mannan, who is also in his final year of residency in pediatric neurology at the GOSH.

Some patients have had brain scans, nerve conduction studies or electroencephalograms (EEGs), including fourteen who showed less electrical activity in their brains, according to the study.

Thirteen of the 24 patients with neurological symptoms had to be put on a ventilator and 15 medications needed to improve their heart contractions, Abdel-Mannan said. In contrast, only 3 of 22 children without neurological problems needed ventilators and 7 needed the drug for their hearts, he said. None of the children with hallucinations required psychotropic medication.

Three children had to be hospitalized again after their initial stay, one for another episode of encephalopathy and two for infectious complications, Abdel-Mannan said, but added that there had been no deaths and that “almost all the children had a full functional recovery”.

Abdel-Mannan said a team led by lead study author Yael Hacohen will follow patients who have had the syndrome, both those who have developed neurological symptoms and those who do not. . They will perform brain scans and cognitive assessments to see if the children are experiencing long-term psychological or cognitive effects.

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