Of patients with life-threatening neurologic conditions, 11 patients (26%) died and 17 (40%) survived with new neurologic sequelae. Children who died included four patients with stroke and four who developed severe encephalopathy. Of survivors with new deficits, 16 (94%) were previously healthy, none had prior neurologic disorders, and 7 (41%) met MIS-C criteria.
“Hispanic or Latino and non-Hispanic Black children and adolescents represented a high proportion of the cases with severe neurologic involvement,” noted co-author Tina Young Poussaint, MD, also of Boston Children’s Hospital.
“There should be a high index of suspicion for COVID-19-related neurologic involvement for any young individual presenting with a broad range of neurologic symptoms or severe neurologic conditions following exposure to COVID-19 or a positive SARS-CoV-2 test,” Poussaint told MedPage Today.
“Minimizing exposure by following the CDC guidelines, even for healthy children, is important because the full extent of neurologic involvement and long-term effects on cognition and development are unknown,” she added.
The study had several limitations, the researchers noted. Cases came only from reporting hospitals and do not reflect the true range and severity of COVID-19 neurologic involvement. In patients with underlying neurologic diseases, some presentations may be an exacerbation of their condition. Not all patients had imaging, and some symptoms, like anosmia or ageusia, may be underreported in very young patients.
This study was funded by the CDC under a contract to Boston Children’s Hospital.
Researchers reported relationships with CDC, NIH, Sanofi, Quidel, Genentech, La Jolla Pharmaceuticals, UpToDate, and Springer Publishing outside of the submitted work.