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神经 COVID-19 伴或不伴多系统炎症综合征(MIS-C):一项单中心研究:COVID-19:儿童的神经系统表现。

Neuro-COVID-19 With or Without the Multisystem Inflammatory Syndrome (MIS-C): A Single-Center Study : COVID-19: Neurologic Manifestations in Children.

机构信息

Departamento de Pediatria, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, 30130-100, Belo Horizonte, MG, Brazil.

Hospital Infantil João Paulo II, FHEMIG, Minas Gerais, Brazil.

出版信息

J Mol Neurosci. 2023 May;73(4-5):250-258. doi: 10.1007/s12031-023-02109-y. Epub 2023 Mar 28.

Abstract

This study evaluates the range of neurological manifestation in children with COVID-19 (neuro-COVID-19) both with and without the multisystem inflammatory syndrome (MIS-C) and the persistence of symptoms after hospital discharge. The study was conducted as a prospective study of children and adolescents under 18 years of age who were admitted to a children's hospital for infectious diseases from January 2021 to January 2022. The children had no previous neurological or psychiatric disorders. Out of the 3021 patients evaluated, 232 were confirmed to have COVID-19 and 21 of these patients (9%) showed neurological manifestations associated with the virus. Of these 21 patients, 14 developed MIS-C, and 7 had neurological manifestations unrelated to MIS-C. There was no statistical difference regarding the neurological manifestations during hospitalization and outcomes between patients with neuro-COVID-19 who had or did not have MIS-C, except for seizures that occurred more frequently in patients with neuro-COVID-19 without MIS-C (p-value = 0.0263). One patient died, and 5 patients still had neurological or psychiatric manifestations at discharge, which persisted for up to 7 months. The study highlights that SARS-CoV-2 infection can affect the central and peripheral nervous system, particularly in children and adolescents with MIS-C, and that it is crucial to be vigilant for long-term adverse outcomes, as the neurological and psychiatric effects of COVID-19 in children are emerging during an important stage of brain development.

摘要

本研究评估了 COVID-19(神经 COVID-19)患儿的神经系统表现范围,包括伴有和不伴有多系统炎症综合征(MIS-C)的患儿,以及出院后症状的持续情况。该研究是一项前瞻性研究,纳入了 2021 年 1 月至 2022 年 1 月期间因传染病入住儿童医院的 18 岁以下儿童和青少年。这些儿童以前没有神经或精神疾病。在评估的 3021 名患者中,有 232 名被确诊为 COVID-19,其中 21 名(9%)出现了与病毒相关的神经系统表现。这 21 名患者中,有 14 名发生了 MIS-C,有 7 名出现了与 MIS-C 无关的神经系统表现。在神经 COVID-19 患者中,有无 MIS-C 与住院期间的神经系统表现和结局之间没有统计学差异,除了无 MIS-C 的神经 COVID-19 患者更常发生癫痫(p 值=0.0263)。有 1 名患者死亡,有 5 名患者出院时仍有神经系统或精神科表现,持续长达 7 个月。本研究强调,SARS-CoV-2 感染可影响中枢和周围神经系统,特别是在伴有 MIS-C 的儿童和青少年中,需要警惕长期不良结局,因为 COVID-19 在儿童中的神经和精神影响在大脑发育的重要阶段出现。

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