Elmira Haji Esmaeil Memar
1 
, Morteza Heidari
2,3 , Homa Ghabeli
2, Elham Pourbakhtyaran
2, Roya Haghighi
2, Seyyed Mohammad Mahdi Hosseiny
2, Setareh Mamishi
4,5, Shima Mahmoudi
5, Hamid Eshaghi
4, Ali Reza Tavasoli
2,3, Mahmoud Mohammadi
2, Reza Shervin Badv
2, Gholamreza Zamani
2, Masood Ghahvehchi Akbari
6, Bahram Yarali
2, Rohola Shirzadi
7, Masoud Mohammadpour
8, Bahareh Yaghmaei
8, Meisam Sharifzadeh Ekbatani
8, Zeynab Najafi
8, Mahmoud Reza Ashrafi
2,9* 1 Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Pediatric Neurology, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
3 Myelin Disorders Clinic, Pediatric Neurology Division, Children’s Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
4 Department of Infectious Diseases, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
5 Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
6 Department of Physical Medicine and Rehabilitation, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
7 Pediatric Respiratory and Sleep Medicine Research Center, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
8 Department of Pediatric Intensive Care, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
9 Pediatric Cell and Gene Therapy Research center, Gene, Cell &Tissue Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Background: COVID-19 infection and its neurological manifestations were seen in children although less common than adults. The aim of this study was to determine the frequency of different types of neurologic findings of hospitalized children with COVID-19. ]
Methods: This retrospective study was performed on hospitalized pediatric patients aged≤18 years with confirmed SARS-CoV-2 at Children’s Medical Center Hospital. Neurological manifestations were defined as the presence of any of the following symptoms: seizure, altered mental status, behavioral/personality change, ataxia, stroke, muscle weakness, smell and taste dysfunctions, and focal neurological disorders.
Results: Fifty-four children with COVID-19 were admitted and their mean age was 6.94±4.06 years. Thirty-four of them (63%) were male. The most frequent neurological manifestation was seizure (19 [45%]) followed by muscle weakness (11 [26%]), loss of consciousness (10 [23%]), and focal neurological disorders (10 [23%]). Other neurological manifestations consisted of headache (n=7), movement disorders (n=6), behavioral/personality change (n=5), ataxia (n=3), and stroke (n=3). Twenty-nine percent of our patients had leukocytosis. A neutrophil count above 70% was seen in 31% of participants. Among our patients, 81% had a positive reverse-transcription polymerase chain reaction (RT-PCR) test for SARS-CoV-2.
Conclusion: During the current pandemic outbreak, hospitalized children with COVID-19 should be evaluated for neurological signs because it is common among them and should not be under-estimated.