A study examines imaging manifestations of the central nervous system of COVID-19 in children

Although brain complications of COVID-19 in children are rare, compared to adults, an international expert study of positive neuroimaging results in children with hungry and post-infectious COVID-19 found that the deficiencies were most common orders resembling patterns of central nervous system disease of the brain, spine, and nerves. Strokes, most commonly reported in adults with COVID-19, were less common in children. The study of 38 children, published in the journal Lancet, the largest to date display of central nervous system imaging of COVID-19 in children.

Thanks to a large international collaboration, we found that neuroimaging manifestations of COVID-19 infection in children could range from mild to severe and that pre-existing conditions were absent. Attention to the neurological effects of COVID-19 and recognition of neuroimaging manifestations that can occur in children can make accurate and timely diagnosis, reduce the spread of the disease, and prevent morbidity and mortality. “

Susan Palasis, MD, Associate Senior Author, Head of the Department of Neuroradiology, Ann & Robert H. Lurie Children ‘s Hospital in Chicago and Associate Professor of Radiation, Northwestern University Feinberg School of Medicine

To understand the neuroimaging findings encountered in a clinical context, Dr. Palasis and his colleagues divided the cases into four categories of disease based on pediatric symptoms and laboratory results. In this way, they were able to simultaneously assess a large number of cases and identify recurrent neuroimaging patterns in the acute and postoperative stages of the disease.

A rare elevation of spinal nerve roots on MRI was observed in many of the cases. This neuroimaging finding is usually seen with Guillain-Barré Syndrome (GBS), a post-infectious autoimmune disease. The study showed that GBS can be related to COVID? 19 presence as a para-infectious infectious process rather than the normal post-infectious neuronal injury.

Another important observation was that cranial nerve augmentation was also frequently present.

“We noted that a neutral zero increase was not always associated with a corresponding zero signal,” Dr. Palasis said. “This indicates that neuroradiologists need to conduct targeted investigations for unexpected anomalies, as they may believe that COVID-19 is the primary cause of the disease.”

Other commonly observed findings were areas of refraction on MRI within a specific area of ​​the brain, splenium of the corpus callosum, and inflammation in the muscles. These were more commonly characterized by multisystemic inflammatory syndrome in children (MIS-C), a severe complication of COVID-19.

Myelitis, an infectious or post-infectious demyelinating condition of the spinal cord, was also a frequent pattern of disease. The majority of cases fell into the spectrum of postoperative process and the children were either routinely followed or had moderate remnants of remnants. One child developed severe myelitis and eventually became quadriceps.

“Our views are that while most children with COVID-19 nervous system disease are doing well, some can have a significant impact on them,” said Dr Palasis. four cases of atrial fibrillation of the central nervous system in previously healthy children diagnosed with COVID-19 starvation, which were predominantly fatal. The results of our study confirm the importance of awareness of the aqueous and less common sequelae of COVID. -19 neurologic disease in children with recent or concomitant COVID-19 infections. Neuroimaging patterns we identified in our study should investigate COVID-19 which may be the etiological factor for disease. “