New UK study reveals extent of brain complications in children
hospitalized with COVID-19

Date:
July 16, 2021
Source:
University of Liverpool
Summary:
Although the risk of a child being admitted to hospital due to
COVID-19 is small, a new UK study has found that around 1 in 20
of children hospitalized with COVID-19 develop brain or nerve
complications linked to the viral infection.



FULL STORY ========================================================================== Although the risk of a child being admitted to hospital due to COVID-19
is small, a new UK study has found that around 1 in 20 of children
hospitalised with COVID-19 develop brain or nerve complications linked
to the viral infection.


==========================================================================
The research, published in The Lancet Child and Adolescent Health and led
by the University of Liverpool, identifies a wide spectrum of neurological complications in children and suggests they may be more common than in
adults admitted with COVID-19.

While neurological problems have been reported in children with the
newly described post-COVID condition paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS), the capacity
of COVID-19 to cause a broad range of nervous system complications in
children has been under- recognised.

To address this, the CoroNerve Studies Group, a collaboration between
the universities of Liverpool, Newcastle, Southampton and UCL, developed
a real- time UK-wide notification system in partnership with the British Paediatric Neurology Association.

Between April 2020 and January 2021, they identified 52 cases of children
less than 18 years old with neurological complications among 1,334
children hospitalised with COVID-19, giving an estimated prevalence of
3.8%. This compares to an estimated prevalence of 0.9% in adults admitted
with COVID-19.

Eight (15%) children presenting with neurological features did not have
COVID- 19 symptoms although the virus was detected by PCR, underscoring
the importance of screening children with acute neurological disorders
for the virus.

Ethnicity was found to be a risk factor, over two thirds of children
being of Black or Asian background.

For the first time, the study identified key differences between
those with PIMS-TS versus those with non-PIMS-TS neurological
complications. The 25 children (48%) diagnosed with PIMS-TS displayed
multiple neurological features including encephalopathy, stroke,
behavioural change, and hallucinations; they were more likely to require intensive care. Conversely, the non-PIMS-TS 27 (52%) children had a
primary neurological disorder such as prolonged seizures, encephalitis
(brain inflammation), Guillain-Barre' syndrome and psychosis. In almost
half of these cases, this was a recognised post-infectious neuro-immune disorder, compared to just one child in the PIMS-TS group, suggesting
that different immune mechanisms are at work.

Short-term outcomes were apparently good in two thirds (65%) although
a third (33%) had some degree of disability and one child died at the
time of follow- up. However, the impacts on the developing brain and longer-term consequences are not yet known.

First author Dr Stephen Ray, a Wellcome Trust clinical fellow and
paediatrician at the University of Liverpool said: "The risk of a child
being admitted to hospital due to COVID-19 is small, but among those hospitalised, brain and nerve complications occur in almost 4%. Our
nationwide study confirms that children with the novel post-infection hyper-inflammatory syndrome PIMS-TS can have brain and nerve problems;
but we have also identified a wide spectrum of neurological disorders
in children due to COVID-19 who didn't have PIMS-TS.

These were often due to the child's immune response after COVID-19
infection." Joint senior-author Dr Rachel Kneen, a Consultant Paediatric Neurologist at Alder Hey Children's NHS Foundation Trust and honorary
clinical Senior Lecturer at the University of Liverpool said: "Many of
the children identified were very unwell. Whilst they had a low risk of
death, half needed intensive care support and a third had neurological disability identified. Many were given complex medication and treatments,
often aimed at controlling their own immune system.

We need to follow these children up to understand the impact in
the long term." Joint senior-author Dr Benedict Michael, a senior
clinician scientist and MRC Fellow at the University of Liverpool
said: "Now we appreciate the capacity for COVID-19 to cause a wide
range of brain complications in those children who are hospitalised
with this disease, with the potential to cause life-long disability,
we desperately need research to understand the immune mechanisms
which drive this. Most importantly- How do we identify those
children at risk and how should we treat them to prevent lasting
brain injury? We are so pleased that the UK government has funded
our COVID-CNS study to understand exactly these questions so that we
can help inform doctors to better recognise and treat these children." ========================================================================== Story Source: Materials provided by University_of_Liverpool. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Stephen T J Ray, Omar Abdel-Mannan, Mario Sa, Charlotte Fuller,
Greta K
Wood, Karen Pysden, Michael Yoong, Helen McCullagh, David Scott,
Martin McMahon, Naomi Thomas, Micheal Taylor, Marjorie Illingworth,
Nadine McCrea, Victoria Davies, William Whitehouse, Sameer Zuberi,
Keira Guthrie, Evangeline Wassmer, Nikit Shah, Mark R Baker,
Sangeeta Tiwary, Hui Jeen Tan, Uma Varma, Dipak Ram, Shivaram Avula,
Noelle Enright, Jane Hassell, Amy L Ross Russell, Ram Kumar, Rachel
E Mulholland, Sarah Pett, Ian Galea, Rhys H Thomas, Ming Lim, Yael
Hacohen, Tom Solomon, Michael J Griffiths, Benedict D Michael,
Rachel Kneen, Gerome Breen, Hannah Castell, Ceryce Collie, Lilly
George, Monika Hartmann, Marc Henrion, Maria Kinali, Christina
Petropoulos, Sithara Ramdas, Victoria Vlachou, Brigitte Vollmer,
Bethany Facer, Cordelia Dunai. Neurological manifestations of
SARS-CoV-2 infection in hospitalised children and adolescents in
the UK: a prospective national cohort study. The Lancet Child &
Adolescent Health, 2021; DOI: 10.1016/S2352-4642(21)00193-0 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/07/210716112443.htm

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