Alves Lucas, Alcântara Thaís, Hazin Adriano, Lucato Leandro, Ferraz de Magalhães Jurandy Júnior, Alves Joao, Meneses Jucille
Department of Neuropediatric (LA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Neonatology (TA, JM), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (AH), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (LL), Hospital das Clínicas da Universidade de São Paulo; Department of Virology (JJFM), Pernambuco State Central Laboratory (LACEN/PE); and Department of Pediatrics (JA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil.
Neurol Clin Pract. 2022 Jun;12(3):e22-e24. doi: 10.1212/CPJ.0000000000001173.
Because the COVID-19 pandemic evolves, reports of neurologic manifestations and neuroimaging associated with SARS-CoV-2 have been reported in children and in neonates, although very few when compared with adults.
To describe a 3-day-old neonate presenting afebrile seizures with a persistent positive nasopharyngeal swab for SARS-CoV-2 and neuroimaging demonstrating extensive cerebral white matter injury.
Consent was obtained to report this case. SARS-CoV-2 was tested using real-time reverse transcriptase-polymerase chain reaction amplification of virus acid from a nasopharyngeal swab. MRI of the brain was performed using axial T1, T2, fluid-attenuated inversion recovery, diffusion-weighted imaging, and T1 postcontrast sequences.
Brain MRI showed restricted diffusion in the periventricular white matter, subcortical white matter, and splenium of the corpus callosum.
Neurologic presentation of SARS-CoV-2 in newborns seems to be rare and is not fully known. SARS-CoV-2 infection should be considered in newborns with seizures and white matter abnormalities.
由于新冠疫情不断演变,儿童和新生儿中已报告了与严重急性呼吸综合征冠状病毒2(SARS-CoV-2)相关的神经系统表现和神经影像学情况,尽管与成人相比非常少见。
描述一名3日龄新生儿,出现无热惊厥,鼻咽拭子严重急性呼吸综合征冠状病毒2检测持续呈阳性,神经影像学显示广泛脑白质损伤。
已获得报告该病例的同意。使用实时逆转录聚合酶链反应对鼻咽拭子中的病毒核酸进行扩增,检测严重急性呼吸综合征冠状病毒2。脑部磁共振成像(MRI)采用轴位T1、T2、液体衰减反转恢复序列、扩散加权成像和T1增强后序列。
脑部MRI显示脑室周围白质、皮质下白质和胼胝体压部扩散受限。
严重急性呼吸综合征冠状病毒2在新生儿中的神经系统表现似乎罕见,且尚未完全明确。对于出现惊厥和白质异常的新生儿,应考虑严重急性呼吸综合征冠状病毒2感染。