COVID-19: long-term effects in children

Pubblicato il

Monday, 24 June 2024

Argomento

Eye infections

A large cohort study reports on the long-term consequences of COVID-19 infection in the population of children under 18 and in the hyper-fragile group of neuro-disabled patients

Paediatric patients hospitalised for COVID-19, the infection caused by the SARS-CoV-2 virus, or for multisystem inflammatory syndrome (MIS-C) often present severe neurological manifestations, which are significantly associated with new neurocognitive or functional morbidities, which may involve visual function, at the time of hospital discharge, according to the results of a study, Severe Paediatric Neurological Manifestations With SARS-CoV-2 or MIS-C Hospitalization and New Morbidity, published in June 2024 in JAMA Network Open.

The researchers, led by Conall Francoeur of the McGill University Health Centre in Montreal (Canada), recruited a large cohort of 3,568 patients under the age of 18 from 46 centres in 10 different countries, admitted between January 2020 and July 2021, with a confirmed or presumed diagnosis of SARS-CoV-2 or MIS-C. Severe neurological manifestations considered included acute encephalopathy, seizures or status epilepticus, meningitis or encephalitis, sympathetic storm or dysautonomia, cardiac arrest, coma, delirium and stroke.

Of the 2,980 patients with SARS-CoV-2, 18% presented severe neurological manifestations during hospitalisation, whereas in the MIS-C group, 24.8% of the 588 patients reported severe neurological complications. Among survivors, SARS-CoV-2 patients with severe neurological manifestations were more likely to develop new neurocognitive or functional morbidities at discharge than those without such manifestations (27.7% versus 14.6%). Patients with MIS-C and severe neurological manifestations also showed a higher incidence of new morbidity (28% versus 15.5%).

The same report reports clinical evidence that individuals under the age of 18 with pre-existing neurological conditions are more likely to develop severe neurological manifestations if they become infected with SARS-CoV-2 or MIS-C.

Francoeur et al's investigation was carried out as a secondary analysis of the Global Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID) and demonstrates that in the case of COVID-19 the fragile population of patients under 18 with functional and neurocognitive impairments requires intensive multidisciplinary monitoring before and after hospitalisation

The data of this study confirm what has already emerged from previous data published in the literature and constitute a unique contribution in the field of paediatric 'neurocritical care'. Moreover, they should contribute to raising clinicians' awareness of the need to consider the links between short-term manifestations and long-term consequences of systemic pathologies in vulnerable paediatric patients.