COVID-19 Virus Seen Linked to Altered Mental Status, Headaches in Hospitalized Children

New study results show that of hospitalized children who tested or were presumed positive for SARS-CoV-2, 44% developed neurological symptoms, and they were more likely to require intensive care than those who did not experience such symptoms.

The common neurologic symptoms were headache and altered mental status, known as acute encephalopathy, according to the results of the study led by investigators at the University of Pittsburgh Medical Center and the University of Pittsburgh School of Medicine.

The preliminary findings, published in Pediatric Neurology, are the first insights from the pediatric arm of GCS-NeuroCOVID, an international, multi-center consortium aimed at understanding how COVID-19 affects the brain and nervous system.

“The SARS-CoV-2 virus can affect pediatric patients in different ways: It can cause acute disease, where symptomatic illness comes on soon after infection, or children may develop an inflammatory condition, multisystem inflammatory syndrome in children [MIS-C], weeks after clearing the virus,” Ericka Fink, MD, pediatric intensivist at UPMC Children’s Hospital of Pittsburgh and associate professor of critical care medicine and pediatrics at the University of Pittsburgh School of Medicine, said in a statement.

“One of the consortium’s big questions was whether neurological manifestations are similar or different in pediatric patients, depending on which of these 2 conditions they have,” she said.

Investigators gathered data on 1493 children from 30 pediatric critical care centers around the world. They found that 86% were diagnosed with acute SARS-CoV-2, and 14% were diagnosed with MIS-C, a rare condition associated with COVID-19.

MIS-C typically appears several weeks after clearing the virus and is characterized by fever, inflammation, and organ dysfunction.

The most common neurological manifestations linked to acute COVID-19 were acute encephalopathy, headaches, and seizures, investigators found.

Meanwhile, the most common neurological manifestations linked to MIS-C were acute encephalopathy, dizziness, and headaches.

Rarer symptoms of both conditions included loss of smell, psychosis, strokes, and vision impairment.

“This study shows that the frequency of neurological manifestations is high, and it may actually be higher than what we found because these symptoms are not always documented in the medical record or assessable. For example, we can’t know if a baby is having a headache,” Fink said.

Neurological manifestations were more common in children with MIS-C compared with those with acute SARS-CoV-2, and children with MIS-C were more likely than those with acute illnesses to have 2 or more neurologic manifestations, the analysis shows.

The investigators recently launched a follow-up study to determine whether acute SARS-CoV-2 and MIS-C, with or without manifestations, have lasting effects on children’s health and quality of life after discharge from the hospital, Fink said.

As of January 3, 2022, there were a total of 6431 reported cases meeting the definition of MIS-C and 55 total deaths, according to the CDC.

Reference

1. COVID virus linked with headaches, altered mental status in hospitalized kids. EurekAlert. News release. January 21, 2022. Accessed January 25, 2022. https://www.eurekalert.org/news-releases/940851

2. Health department-reported cases of multisystem inflammatory syndrome in children (MIS-C) in the United States. CDC. Updated January 3, 2022. Accessed January 25, 2022. https://covid.cdc.gov/covid-data-tracker/#mis-national-surveillance