Association of SARS-CoV-2 infection with neurological impairments in pediatric population: A systematic review.

Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada. Electronic address: angela.kwan@mail.utoronto.ca. Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia. Electronic address: j.portnoff@uq.net.au. Political Science and International Relations, American University in the Emirates, United Arab Emirates. Electronic address: khaled.alkassimi@aue.ae. Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. Electronic address: gurkaran.singh@ubc.ca. Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada. Electronic address: mehrshad.hanafimosalman@mail.mcgill.ca. Department of Criminology & Socio-Legal Studies and Political Science, University of Toronto, Toronto, ON, Canada. Electronic address: maria.tesla@mail.utoronto.ca. Department of Medicine, Saint James School of Medicine Anguilla, The Valley, Anguilla. Electronic address: nima.gharibi@mail.utoronto.ca. Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada. Electronic address: tiffany.ni@mail.utoronto.ca. Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada. Electronic address: ziji.guo@mail.utoronto.ca. Faculty of Medicine, Laval University, Québec, QC, Canada. Electronic address: davaine-joel.ndongo-sonfack.1@ulaval.ca. Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada. Electronic address: julia.martyniuk@utoronto.ca. Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada; Department of Molecular and Cell Biology, University of California Berkeley, Berkeley, CA, United States of America. Electronic address: saman.arfaie@berkeley.edu. Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia. Electronic address: sadegh@student.ubc.ca. School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom. Electronic address: mohammad.mofatteh@gmail.com. Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada. Electronic address: richie.jeremian@mail.mcgill.ca. Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada. Electronic address: k12ho@ryerson.ca. Department of Neurosurgery, University of Cartagena, Cartagena de Indias, Colombia. Electronic address: rafaelmoscote21@gmail.com. Department of Neurosurgery, Comprehensive Stroke Unit, Hospital Ángeles del Pedregal, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, 14000, Mexico. Electronic address: dr_angel_lee@yahoo.de. Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada. Electronic address: youshayjwd@gmail.com. Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada. Electronic address: felicia.ceban@mail.utoronto.ca. Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada. Electronic address: kayla.teopiz@mail.utoronto.ca. Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Electronic address: rodrigo.mansur@uhn.ca. Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Queenstown, Singapore; Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Queenstown, Singapore. Electronic address: pcmrhcm@nus.edu.sg. Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Electronic address: joshua.rosenblat@uhn.ca. Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China. Electronic address: bingcao@swu.edu.cn. Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, United States of America; VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, Bedford, United States of America; Department of Public Health Sciences, School of Medicine, University of Connecticut, Storrs, CT, United States of America. Electronic address: rhee@uchc.edu. Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. Electronic address: roger.mcintyre@bcdf.org.

Journal of psychiatric research. 2024;:90-110
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Abstract

Neurological manifestations have been widely reported in adults with COVID-19, yet the extent of involvement among the pediatric population is currently poorly characterized. The objective of our systematic review is to evaluate the association of SARS-CoV-2 infection with neurological symptoms and neuroimaging manifestations in the pediatric population. A literature search of Cochrane Library; EBSCO CINAHL; Global Index Medicus; OVID AMED, Embase, Medline, PsychINFO; and Scopus was conducted in accordance with the Peer Review of Electronic Search Strategies form (October 1, 2019 to March 15, 2022). Studies were included if they reported (1) COVID-19-associated neurological symptoms and neuroimaging manifestations in individuals aged <18 years with a confirmed, first SARS-CoV-2 infection and were (2) peer-reviewed. Full-text reviews of 222 retrieved articles were performed, along with subsequent reference searches. A total of 843 no-duplicate records were retrieved. Of the 19 identified studies, there were ten retrospective observational studies, seven case series, one case report, and one prospective cohort study. A total of 6985 individuals were included, where 12.8% (n = 892) of hospitalized patients experienced neurocognitive impairments which includes: 1) neurological symptoms (n = 294 of 892, 33.0%), 2) neurological syndromes and neuroimaging abnormalities (n = 223 of 892, 25.0%), and 3) other phenomena (n = 233 of 892, 26.1%). Based on pediatric-specific cohorts, children experienced more drowsiness (7.3% vs. 1.3%) and muscle weakness (7.3% vs. 6.3%) as opposed to adolescents. Agitation or irritability was observed more in children (7.3%) than infants (1.3%). Our findings revealed a high prevalence of immune-mediated patterns of disease among COVID-19 positive pediatric patients with neurocognitive abnormalities.

Methodological quality

Publication Type : Case Reports ; Review

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