Neurological and psychological manifestations in COVID-19 convalescent pediatric patients
Keywords:
convalescence, neurologic manifestations, psychic symptoms, post cute COVID-19 syndrome, pediatric.Abstract
Introduction: The ability of SARS-CoV-2 to produce neurological and psychological manifestations is unquestionable, although they are not, at first glance, distinguishable from those caused by other viral infections. Up to now, it is not possible to determine if these identified sequelae are temporary or permanent; what is known is that some of these symptoms may persist over time regardless of the severity of the disease.Objective: Characterize the main neurological and psychological manifestations found in children under 18 years of age in the period of convalescence of COVID-19.
Methods: A cross-sectional descriptive observational study was carried out, in the period between March 2020 and February 2021; 472 patients were interviewed by telephone, initially between 20 and 35 days after discharge and then 15 days after the first interview. Age, sex, personal pathological history, symptoms at diagnosis, whether these symptoms had improved or disappeared by the time of the interview, and whether they had returned to their usual state of health were collected.
Results: The manifestations were more frequent in the male sex (65%), in those older than 5 years (79.1%), who presented comorbidities and symptoms during the infection. Headache (39.2%), fatigue (22.5%) and myalgias (12.5%) predominated.
Conclusions: The presence of neurological and psychological manifestations occurs more frequently in adolescents and male schoolchildren with symptomatic forms of the disease and the existence of personal pathological history.
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References
1. Zepeda G, Tapia L, Ortiz P. Infección por SARS-CoV-2 y enfermedad por coronavirus-2019 en pediatría. Revista Chilena De Enfermedades Respiratorias. 2020; 36(2):122-3. DOI: 10 .4067/S0717-73482020000200122
2. Hoang A, Chorath K, Moreira A, Evans M, Burmeister-Morton F, Burmeister F, et al. COVID-19 in 7780 pediatric patients: Asystematic review. EClinical Medicine. 2020; 24:100433. DOI: 10.1016/j.eclinm.2020.100433
3. Acosta J, Pérez M, Rodríguez M, Morales A. COVID-19 en pediatría: aspectos clínicos, epidemiológicos, inmunopatogenia, diagnóstico y tratamiento. Rev Cubana Pediatr. 2020 [acceso: 05/05/2022]; 92(Suppl 1):e1152. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S003475312020000500007&lng=es
4. Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020; 5(4):536-44. DOI: 10.1038/s41564-020-0695-z
5. Ribeiro SJ, Targino C, Miranda K, Pesso^a R, Pardee K, Kohl A, et al. Clinical and Laboratory Diagnosis of SARS-CoV-2, the Virus Causing COVID-19. ACS Infect. Dis. 2020; 6(9):2319-36. DOI: 10.1021/acsinfecdis.0c00274
6. Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020; 579(7798):270-3. DOI: 10.1038/s41586-020-2012-7
7. Organización Mundial de la Salud. Informe técnico Coronavirus, Declaración sobre la segunda reunión del Comité de Emergencias del Reglamento Sanitario Internacional (2005) acerca del brote del nuevo coronavirus (2019-nCoV). Ginebra: OMS; 2020. [acceso: 05/05/2022]. Disponible en: https://www.who.int/es/news/item/13-04-2022-statement-on-the-eleventh-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic
8. Carod-Artal FJ. Síndrome post-COVID-19: epidemiología, criterios diagnósticos y mecanismos patogénicos implicados. Rev Neurol. 2021; 72:384-96. DOI: 10.33588/rn.7211.2021230
9. Gutiérrez BD, Mosqueda MEE, Joaquín VH, Morales FJA, Cruz SAX, Chávez AJE et al. Efectos a largo plazo de la COVID-19: una revisión de la literatura. Acta Med Grupo Angeles. 2021; 19(3):421-8. DOI: 10.35366/101741
10. Office for National Statistics (ONS). The prevalence of long COVID symptoms and COVID-19 complications. Statements and letters. [actualizado: 16/12/2020; acceso: 05/05/2022]. Disponible en: https://www.ons.gov.uk/news/statementsandletters/theprevalenceoflongcovidsymptomsandcovid19complications
11. Bouza E, Cantón R, De Lucas P, García-Botella A, García-Lledó A, Gómez-Pavón J, et al. Síndrome post-COVID: Un documento de reflexión y opinión. Rev Esp Quimioter. 2021; 34(4):269-27. DOI: 10.37201/req/023.2021
12. Peña Martínez SL, Bello Quezada ME, Segura Lemus V. Manifestaciones neurológicas y COVID-19. Alerta. 2021 [acceso: 05/05/2022]; 4(2):69-80. Disponible en: https://docs.bvsalud.org/biblioref/2021/05/1247335/manifestaciones-neurologicas-y-covid-19.pdf
13. Cañón FH, Rivera MJ, Puente TC, Lozarda ID, Moscote LR. Síndrome Post-COVID19: Examen de Fenotipos. Archivos de medicina. 2021 [acceso: 05/05/2022]; 17(S3):5. Disponible en: https://www.archivosdemedicina.com/medicina-de-familia/sindrome-post-covid-19-de-que-se-trata.pdf
14. Boix V, Meriño E. Síndrome post-COVID. El desafío continúa. Med Clin. 2022; 158(4):178-80. DOI: 10.1016/j.medcli.2021.10.002
15. Gemelli Against COVID-19 Post-Acute Care Study Group. Post-COVID-19 global health strategies: the need for an interdisciplinary approach. Aging Clin Exp Res. 2020; 32(8):1613-20. DOI: 10.1007/s40520-020-01616-x
16. Greenhalgh T, Knight M, A´Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care BMJ. 2020; 370:3026. DOI: 10.1136/bmj.m3026
17. Klok FA, Boon G, Barco S, Endres M, Miranda JJ, Knauss S, et al. The Post-COVID-19 Functional Status scale: a tool to measure functional status over time after COVID-19. Eur Respir J. 2020; 56(1):2001494. DOI: 10.1183/13993003.01494-2020
18. Cimas JE. Seguimiento de los pacientes con secuelas no respiratorias de la COVID-19. FMC. 2021; 28(2):81-9. DOI: 10.1016/j.fmc.2020.11.004
19. Tamhane AR, Westfall AO, Burkholder GA, Cutter GR. revalence Odds Ratio versus Prevalence Ratio: Choice Comes with Consequences. Stat Med. 2016; 35(30):5730-5. DOI: 10.1002/sim.7059
20. MedCalc Software Ltd. Comparison of two rates. Version 22.007. [acceso: 05/05/2022]. Disponible en: https://www.medcalc.org/calc/rate_comparison.php
21. Cortés ME. Efectos Neurológicos y Psicológicos de COVID-19 en Niños y Adolescentes. Revista Ecuatoriana de Neurología. 2020 [acceso: 05/12/2022]; 29(2):12-13. Disponible en: http://revecuatneurol.com/wp-content/uploads/2020 /11/2631-2581-rneuro-26-02-00012.pdf
22. Ley L, Pérez FE, López LR, Noa MD, Satorre JA. Aspectos clínicos, epidemiológicos y cardiovasculares en niños convalecientes por COVID 19 en Villa Clara, Cuba. Revista Cubana de Pediatría. 2021 [acceso: 05/05/2022]; 93(1):e1335. Disponible en: https://revpediatria.sld.cu/index.php/ped/article/view/1335
23. Tessman R, Rosko MA. Neurologic and radigographic findings associated with pediatric inflammatory multisystem syndrome temporarily associated with SARS-CoV-2 (PIMS-TS) in children. Developmental Medicine and Child Neurology. 2022 [acceso: 05/09/2022]; 64(SUPPL 1):23. Disponible en: https://pesquisa.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/pt/covidwho-1723122
24. García S, Cuatepotzo FM, Toledo CG, Balderrama A, Alcaraz SL, Montiel-López L, et al. Neurological manifestations and outcomes in a retrospective cohort of mexican inpatients with SARS-CoV-2 pneumonia: Design of a risk profile. Healthcare (Switzerland). 2021; (11):1501. DOI: 10.3390/healthcare9111501
25. Tenforde MW, Kim SS, Christopher JL, Rose E, Shapiro N, D Clark Files, et al. Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network - United States March-June 2020. MMWR Morbidity and Mortality Weekly Report. 2020; 69(30):993-8. DOI: 10.15585/mmwr.mm6930e1
26. Evans RA, McAuley H, Harrison EM, Shikotra A, Singapuri A, Sereno M, et al. Physical, cognitive, and mental health impacts of COVID-19 after hospitalisation (PHOSP-COVID): a UK multicentre, prospective cohort study. Lancet Respir Med. 2021; 9:1275-87. DOI: 10.1016/S2213-2600(21)00383-0
27. Monsalve AM, Navarro CJ, Benavides KM, Giraldo YA, Romero MP. Clinical Manifestations in the Pediatric Patient with Post-COVID-19 Syndrome: A New Challenge for the Preservation of Functional Capacity. Int J Pediatr Res. 2022; 8:091. DOI: 10.23937/2469-5769/1510091
28. Lopez S, Wegman T, Perelman C, Sepulveda R, Rebolledo PA. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep. 2021; 11(1):16144. DOI: 10.1101/2021.01.27.21250617
29. Pitossi F. El posible rol de la inflamación en las secuelas neurológicas del COVID-19. Neurología Argentina. 2021; 13(3):135-6. DOI: 10.1016/j.neuarg. 2021.09.001
30. Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021; 397(10270):220-32. DOI: 10.1016/S0140-6736(20)32656-8
31. Galván CE, Herrera CF, Godina S, Villagrana KE, Amaro JDL, Herrera-García H, et al. Persistence of COVID-19 Symptoms after Recovery in Mexican Population. Int J Environ Res Public Health. 2020; 17(24):9367. DOI: 10.3390/ijerph17249367
32. Favas TT, Dev P, Chaurasia RN, Chakravarty K, Mishra R, Deepika J, et al. Neurological manifestations of COVID-19: a systematic review and meta-analysis of proportions. Neurol Sci. 2020; 41(12):3437-70. DOI: 10.1007/s10072-020-04801-y
33. Liotta EM, Batra A, Clark JR, Shlobin NA, Hoffman SC, et al. Frequent neurologic manifestations and encephalopathy-associated morbidity in Covid-19 patients. Ann Clin Transl Neurol. 2020; 7(11):2221-30. DOI: 10.1002/acn3.51210
34. Writing Committee for the COMEBAC Study Group; Morin L, Savale L, Pham T, Colle R, Figueiredo S, Harrois A. Writing committee for the COMEBAC Study Group. Four-month clinical status of a cohort of patients after hospitalization for COVID-19. JAMA. 2021; 325(15):1525-34. DOI: 10.1001/jama.2021.3331
2. Hoang A, Chorath K, Moreira A, Evans M, Burmeister-Morton F, Burmeister F, et al. COVID-19 in 7780 pediatric patients: Asystematic review. EClinical Medicine. 2020; 24:100433. DOI: 10.1016/j.eclinm.2020.100433
3. Acosta J, Pérez M, Rodríguez M, Morales A. COVID-19 en pediatría: aspectos clínicos, epidemiológicos, inmunopatogenia, diagnóstico y tratamiento. Rev Cubana Pediatr. 2020 [acceso: 05/05/2022]; 92(Suppl 1):e1152. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S003475312020000500007&lng=es
4. Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020; 5(4):536-44. DOI: 10.1038/s41564-020-0695-z
5. Ribeiro SJ, Targino C, Miranda K, Pesso^a R, Pardee K, Kohl A, et al. Clinical and Laboratory Diagnosis of SARS-CoV-2, the Virus Causing COVID-19. ACS Infect. Dis. 2020; 6(9):2319-36. DOI: 10.1021/acsinfecdis.0c00274
6. Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020; 579(7798):270-3. DOI: 10.1038/s41586-020-2012-7
7. Organización Mundial de la Salud. Informe técnico Coronavirus, Declaración sobre la segunda reunión del Comité de Emergencias del Reglamento Sanitario Internacional (2005) acerca del brote del nuevo coronavirus (2019-nCoV). Ginebra: OMS; 2020. [acceso: 05/05/2022]. Disponible en: https://www.who.int/es/news/item/13-04-2022-statement-on-the-eleventh-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic
8. Carod-Artal FJ. Síndrome post-COVID-19: epidemiología, criterios diagnósticos y mecanismos patogénicos implicados. Rev Neurol. 2021; 72:384-96. DOI: 10.33588/rn.7211.2021230
9. Gutiérrez BD, Mosqueda MEE, Joaquín VH, Morales FJA, Cruz SAX, Chávez AJE et al. Efectos a largo plazo de la COVID-19: una revisión de la literatura. Acta Med Grupo Angeles. 2021; 19(3):421-8. DOI: 10.35366/101741
10. Office for National Statistics (ONS). The prevalence of long COVID symptoms and COVID-19 complications. Statements and letters. [actualizado: 16/12/2020; acceso: 05/05/2022]. Disponible en: https://www.ons.gov.uk/news/statementsandletters/theprevalenceoflongcovidsymptomsandcovid19complications
11. Bouza E, Cantón R, De Lucas P, García-Botella A, García-Lledó A, Gómez-Pavón J, et al. Síndrome post-COVID: Un documento de reflexión y opinión. Rev Esp Quimioter. 2021; 34(4):269-27. DOI: 10.37201/req/023.2021
12. Peña Martínez SL, Bello Quezada ME, Segura Lemus V. Manifestaciones neurológicas y COVID-19. Alerta. 2021 [acceso: 05/05/2022]; 4(2):69-80. Disponible en: https://docs.bvsalud.org/biblioref/2021/05/1247335/manifestaciones-neurologicas-y-covid-19.pdf
13. Cañón FH, Rivera MJ, Puente TC, Lozarda ID, Moscote LR. Síndrome Post-COVID19: Examen de Fenotipos. Archivos de medicina. 2021 [acceso: 05/05/2022]; 17(S3):5. Disponible en: https://www.archivosdemedicina.com/medicina-de-familia/sindrome-post-covid-19-de-que-se-trata.pdf
14. Boix V, Meriño E. Síndrome post-COVID. El desafío continúa. Med Clin. 2022; 158(4):178-80. DOI: 10.1016/j.medcli.2021.10.002
15. Gemelli Against COVID-19 Post-Acute Care Study Group. Post-COVID-19 global health strategies: the need for an interdisciplinary approach. Aging Clin Exp Res. 2020; 32(8):1613-20. DOI: 10.1007/s40520-020-01616-x
16. Greenhalgh T, Knight M, A´Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care BMJ. 2020; 370:3026. DOI: 10.1136/bmj.m3026
17. Klok FA, Boon G, Barco S, Endres M, Miranda JJ, Knauss S, et al. The Post-COVID-19 Functional Status scale: a tool to measure functional status over time after COVID-19. Eur Respir J. 2020; 56(1):2001494. DOI: 10.1183/13993003.01494-2020
18. Cimas JE. Seguimiento de los pacientes con secuelas no respiratorias de la COVID-19. FMC. 2021; 28(2):81-9. DOI: 10.1016/j.fmc.2020.11.004
19. Tamhane AR, Westfall AO, Burkholder GA, Cutter GR. revalence Odds Ratio versus Prevalence Ratio: Choice Comes with Consequences. Stat Med. 2016; 35(30):5730-5. DOI: 10.1002/sim.7059
20. MedCalc Software Ltd. Comparison of two rates. Version 22.007. [acceso: 05/05/2022]. Disponible en: https://www.medcalc.org/calc/rate_comparison.php
21. Cortés ME. Efectos Neurológicos y Psicológicos de COVID-19 en Niños y Adolescentes. Revista Ecuatoriana de Neurología. 2020 [acceso: 05/12/2022]; 29(2):12-13. Disponible en: http://revecuatneurol.com/wp-content/uploads/2020 /11/2631-2581-rneuro-26-02-00012.pdf
22. Ley L, Pérez FE, López LR, Noa MD, Satorre JA. Aspectos clínicos, epidemiológicos y cardiovasculares en niños convalecientes por COVID 19 en Villa Clara, Cuba. Revista Cubana de Pediatría. 2021 [acceso: 05/05/2022]; 93(1):e1335. Disponible en: https://revpediatria.sld.cu/index.php/ped/article/view/1335
23. Tessman R, Rosko MA. Neurologic and radigographic findings associated with pediatric inflammatory multisystem syndrome temporarily associated with SARS-CoV-2 (PIMS-TS) in children. Developmental Medicine and Child Neurology. 2022 [acceso: 05/09/2022]; 64(SUPPL 1):23. Disponible en: https://pesquisa.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/pt/covidwho-1723122
24. García S, Cuatepotzo FM, Toledo CG, Balderrama A, Alcaraz SL, Montiel-López L, et al. Neurological manifestations and outcomes in a retrospective cohort of mexican inpatients with SARS-CoV-2 pneumonia: Design of a risk profile. Healthcare (Switzerland). 2021; (11):1501. DOI: 10.3390/healthcare9111501
25. Tenforde MW, Kim SS, Christopher JL, Rose E, Shapiro N, D Clark Files, et al. Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network - United States March-June 2020. MMWR Morbidity and Mortality Weekly Report. 2020; 69(30):993-8. DOI: 10.15585/mmwr.mm6930e1
26. Evans RA, McAuley H, Harrison EM, Shikotra A, Singapuri A, Sereno M, et al. Physical, cognitive, and mental health impacts of COVID-19 after hospitalisation (PHOSP-COVID): a UK multicentre, prospective cohort study. Lancet Respir Med. 2021; 9:1275-87. DOI: 10.1016/S2213-2600(21)00383-0
27. Monsalve AM, Navarro CJ, Benavides KM, Giraldo YA, Romero MP. Clinical Manifestations in the Pediatric Patient with Post-COVID-19 Syndrome: A New Challenge for the Preservation of Functional Capacity. Int J Pediatr Res. 2022; 8:091. DOI: 10.23937/2469-5769/1510091
28. Lopez S, Wegman T, Perelman C, Sepulveda R, Rebolledo PA. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep. 2021; 11(1):16144. DOI: 10.1101/2021.01.27.21250617
29. Pitossi F. El posible rol de la inflamación en las secuelas neurológicas del COVID-19. Neurología Argentina. 2021; 13(3):135-6. DOI: 10.1016/j.neuarg. 2021.09.001
30. Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021; 397(10270):220-32. DOI: 10.1016/S0140-6736(20)32656-8
31. Galván CE, Herrera CF, Godina S, Villagrana KE, Amaro JDL, Herrera-García H, et al. Persistence of COVID-19 Symptoms after Recovery in Mexican Population. Int J Environ Res Public Health. 2020; 17(24):9367. DOI: 10.3390/ijerph17249367
32. Favas TT, Dev P, Chaurasia RN, Chakravarty K, Mishra R, Deepika J, et al. Neurological manifestations of COVID-19: a systematic review and meta-analysis of proportions. Neurol Sci. 2020; 41(12):3437-70. DOI: 10.1007/s10072-020-04801-y
33. Liotta EM, Batra A, Clark JR, Shlobin NA, Hoffman SC, et al. Frequent neurologic manifestations and encephalopathy-associated morbidity in Covid-19 patients. Ann Clin Transl Neurol. 2020; 7(11):2221-30. DOI: 10.1002/acn3.51210
34. Writing Committee for the COMEBAC Study Group; Morin L, Savale L, Pham T, Colle R, Figueiredo S, Harrois A. Writing committee for the COMEBAC Study Group. Four-month clinical status of a cohort of patients after hospitalization for COVID-19. JAMA. 2021; 325(15):1525-34. DOI: 10.1001/jama.2021.3331
Published
2023-08-11
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Alvarez Cruz J, Blanco del Frade A, Carassou Gutiérez M, Arteche Hidalgo LL, Romero Reinaldo Y, Santamaria Trujillo CL. Neurological and psychological manifestations in COVID-19 convalescent pediatric patients. Rev Cubana Med Milit [Internet]. 2023 Aug. 11 [cited 2025 Apr. 19];52(3):e02302744. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/2744
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