The minority of coronavirus patients had been children below the age of 18 since older ages are more susceptible to the spread of infection. Medical experts have observed that younger ages showed slightly different symptoms as adults, such as a new inflammatory syndrome and more recently, neurological symptoms.
Previously, medical experts linked COVID-19 to a new condition found only in young ages called Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2 (PIMS-TS), a Kawasaki disease copycat. A group of doctors from the Great Ormond Street Hospital for Children in London observed symptoms affecting children's central and peripheral nervous systems as they picked up changes in the brain's splenium.
The splenium is the thick layered, rear end (posterior portion) of the corpus callosum, the C-shaped nerve tract right under the cerebral cortex which is full of commissural fibers connecting both hemispheres of the brain. Diseases that cause problems to the splenium of corpus callosum (SCC) result in confusion, ataxia (nervous system disease), dysarthria (motor speech disorder), and seizures.
The diagnosis is more commonly known as a splenial lesion, which is linked to seizures. A previous study from China reported 78 adults with similar symptoms of slurred speech, stumbling, seizures, and acute cerebrovascular disease as a result of encephalitis.
Absence of Respiratory Symptoms
Dr. Ming Lim from King's College London said, 'this group of [PIMS-TS] children, now in excess of 150 cases seen in London and up to 300 in the UK, initially present with a high fever, rash, conjunctivitis and abdominal pain, progress to have multi-organ failure often requiring prolonged high-level intensive care support.
Dr. Omar Abdel-Mannan, an author in the study, and his team analyzed data from 27 children who obtained the inflammatory syndrome after testing positive for coronavirus. Their results showed four patients suffered from neurological symptoms such as encephalopathy, brainstem and cerebellar changes, weak muscles, and headaches.
As they were moved to intensive care, splenium signal changes were picked up in their magnetic resonance imaging (MRI) results. What was also surprising, the authors noted, was the absence of respiratory symptoms associated with coronavirus.
Neurological Symptoms
The team took samples of cerebrospinal fluid (CSF) from two patients, which showed no evidence of infection on polymerase chain reaction, which normally detects the presence of harmful antigens in the body. Oligoclonal band test results were also negative, or immunoglobulins from the CSF used to trace neurological and blood diseases.
Instead, the changes in the patients' neurology were observed as they underwent electroencephalography, resulting in slow activity associated with mild myopathic and neuropathic disorders. They also underwent nerve conduction studies where two of the patients made a full recovery.
'Clinicians should be adding SARS-CoV-2 to their differential diagnosis for children presenting with new neurologic symptoms,' the authors suggested. Lim also added, 'longer-term neurological course and subsequent sequelae of this condition now requires urgent evaluation,' since 'the potential for future relapse, and how these impact on health and neurological, psychological and cognitive outcome,' remain unknown.'
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