Encephalitis Associated with COVID-19 in a7-Year-Old Boy: A Case Report
Abstract
Coronaviruses (CoVs) are single-stranded RNA viruses described for >50 years. Novel coronavirus (SARS-Coronavirus-2: SARS-CoV-2) emerged in Wuhan and has spread globally. Coronavirus Disease 2019 (COVID-19) symptoms are primarily pulmonary (fever, dry cough, fatigue, pneumonia); however, other organs can be affected, including the gastrointestinal tract, kidneys, liver, heart, and brain.
Pediatric COVID-19 is milder than the adult’s type. Children with severe disease often have an underlying co-morbidity, such as chronic lung disease or immunosuppression.
SARS-CoV-1, MERS-CoV, HCoV-OC43, and HCoV-229E are associated with neurological complications. Neurological manifestations of COVID-19 are not well understood in adults or children, and these manifestations are not rare. The number of patients with neurological manifestations has been increasing Recently, especially in the third peak of the disease.
Early diagnosis and timely management may lead to a better outcome. There are limited reports of neurological complications in the pediatric population. Further studies are required for early diagnosis and better results. We reported the third case of encephalitis in children without any respiratory or gastrointestinal manifestation.
A 7-year-old male was admitted with fever and loss of consciousness. He presented no respiratory or gastrointestinal symptoms. He reported no medical history and history of substance abuse. Laboratory findings confirm that neurological manifestations might be expected in covid-19 infections, despite the absence of respiratory symptoms. The patient was treated, and the level of consciousness was gradually improving. Supportive treatment and outpatient follow-up were recommended.
[2] Asadi-Pooya AA, Simani L. Central nervous system manifestations of COVID-19: A systematic review. Journal of the Neurological Sciences. 2020; 413:116832. [DOI:10.1016/j.jns.2020.116832] [PMID] [PMCID]
[3] Needham EJ, Chou SH-Y, Coles AJ, Menon DK. Neurological implica- tions of COVID-19 infections. Neurocritical Care. 2020; 32:(3)667-71. [DOI:10.1007/s12028-020-00978-4] [PMID] [PMCID]
[4] Paybast S, Emami A, Koosha M, Baghalha F. Novel coronavirus disease (COVID-19) and central nervous system complications: What neurologist need to know. Acta Neurologica Taiwanica. 2020; 29(1):24-31. [PMID]
[5] Helms J, Kremer S, Merdji H, Clere-Jehl R, Schenck M, Kummer- len C, et al. Neurologic features in severe SARS-CoV-2 infection. The New England Journal of Medicine. 2020; 382(23):2268-70. [DOI:10.1056/NEJMc2008597] [PMID] [PMCID]
[6] Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic mani- festations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurology. 2020; 77(6):683-90. [DOI:10.1001/ jamaneurol.2020.1127] [PMID] [PMCID]
[7] Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the COVID-19 virus targeting the CNS: Tissue distribution, host-virus interaction, and pro- posed neurotropic mechanisms. ACS Chemical Neuroscience. 2020; 11:995-8. [DOI:10.1021/acschemneuro.0c00122] [PMID] [PMCID]
[8] Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain, Behavior, and Immunity. 2020; 87:18-22. [DOI:10.1016/j.bbi.2020.03.031] [PMID] [PMCID]
[9] Paterson RW, Brown RL, Benjamin L, Nortley R, Wiethoff S, Bharu- cha T, et al. The emerging spectrum of COVID-19 neurology: Clinical, radiological and laboratory findings. Brain. 2020; 143(10):3104-20. [DOI:10.1093/brain/awaa240] [PMID] [PMCID][10] Koralnik IJ, Tyler KL. COVID-19: A global threat to the nervous system. Annals of Neurology. 2020; 88(1):1-11. [DOI:10.1002/ ana.25807] [PMID] [PMCID]
[11] Balasubramanian S, Rao NM, Goenka A, Roderick M, Ramanan AV. Coronavirus disease 2019 (COVID-19) in children- what we know so far and what we do not. Indian Pediatrics. 2020; 57(5):435-42. [DOI:10.1007/s13312-020-1819-5] [PMID] [PMCID]
[12] Zimmermann P, Curtis N. Coronavirus infections in children including COVID19. The Pediatric Infectious Disease Journal. 2020; 39(5):355-68. [DOI:10.1097/INF.0000000000002660] [PMID] [PMCID]
[13] Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiology of COV- ID-19 among children in China. Pediatrics 2020; 145(6):e20200702. [DOI:10.1542/peds.2020-0702] [PMID]
[14] Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72,314 cases from the Chinese center for disease control and prevention. JAMA. 2020; 323(13):1239-42. [DOI:10.1001/jama.2020.2648] [PMID]
[15] Tezer H, Demirdag TB. Novel coronavirus disease (COVID-19) in children. Turkish Journal of Medical Sciences. 2020; 50:592-603. [DOI:10.3906/sag-2004-174] [PMID] [PMCID]
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Issue | Vol 6 No 6 (2021): November-December | |
Section | Case Report(s) | |
DOI | https://doi.org/10.18502/crcp.v6i6.9171 | |
Keywords | ||
Coronavirus disease 2019 COVID-19 Child Encephalitis |
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