Neurologic effects of COVID-19 persisted among pediatric populations in 2021

SARS-CoV-2-related neurologic effects endured among children and adolescents in the United States who were hospitalized in 2021 for COVID-19 or multisystem inflammatory syndrome, researchers reported in JAMA Neurology.

Kerri L. LaRovere, MD, assistant professor of neurology at Boston Children’s Hospital, and colleagues sought to provide an update on the spectrum of COVID-19-related neurologic involvement among children and adolescents in 2021.

Researchers conducted a case series investigation of patients reported to public health surveillance who were hospitalized with a COVID-19-related illness from Dec. 15, 2020, through all of 2021, in 55 U.S. hospitals in 31 states.

A total of 2,253 patients were enrolled, of whom 2,168 were included in the analysis (mean age, 10.3 years; 58% boys). Of those, 1,435 (66%) had multisystem inflammatory syndrome (MIS-C) and 476 (22%) had documented neurologic involvement.

According to the authors, those with neurologic involvement were older compared with those without (median age, 12 vs. 10 years) and more often had underlying neurologic disorders (22% vs. 14%).

Among patients with neurologic involvement, 9% (n = 42) developed life-threatening conditions, including central nervous system infection or demyelination (n = 23), stroke (n = 11), severe encephalopathy (n = 5), acute fulminant cerebral edema (n = 2) and Guillain-Barré syndrome (n = 1).

Nearly 25% of patients survived with new neurologic deficits at hospital discharge, while eight children died (19%). Of those with life-threatening neurologic conditions, the majority of vaccine-eligible patients were unvaccinated (94%).

“COVID-19 vaccination became available for adolescents and children during 2021, but most vaccine-eligible patients were unvaccinated,” the authors wrote. “COVID-19 vaccination is effective at preventing hospitalization for acute COVID-19 and MIS-C and may decrease associated neurologic complications.”