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Journal Articles The Journal of Pediatrics Year : 2022

Neuroinflammatory Disease following Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children

Cyril Gitiaux
Romain Basmaci
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  • IdRef : 137467362

Abstract

Objective To describe neurologic, radiologic and laboratory features in children with central nervous system (CNS) inflammatory disease complicating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Study design We focused on CNS inflammatory diseases in children referred from 12 hospitals in the Paris area to Necker-Sick Children Reference Centre. Results We identified 19 children who had a history of SARS-CoV-2 infection and manifest a variety of CNS inflammatory diseases: encephalopathy, cerebellar ataxia, acute disseminated encephalomyelitis, neuromyelitis optica spectrum disorder, or optic neuritis. All patients had a history of SARS-CoV-2 exposure, and all tested positive for circulating antibodies against SARS-CoV-2. At the onset of the neurologic disease, SARS-CoV-2 PCR results (nasopharyngeal swabs) were positive in 8 children. Cerebrospinal fluid was abnormal in 58% (11/19) and magnetic resonance imaging was abnormal in 74% (14/19). We identified an autoantibody co-trigger in 4 children (myelin-oligodendrocyte and aquaporin 4 antibodies), representing 21% of the cases. No autoantibody was found in the 6 children whose CNS inflammation was accompanied by a multisystem inflammatory syndrome in children. Overall, 89% of patients (17/19) received anti-inflammatory treatment, primarily high-pulse methylprednisolone. All patients had a complete long-term recovery and, to date, no patient with autoantibodies presented with a relapse. Conclusions SARS2-CoV-2 represents a new trigger of postinfectious CNS inflammatory diseases in children.

Dates and versions

hal-03941125 , version 1 (16-01-2023)

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Melodie Aubart, Charles-Joris Roux, Chloé Durrleman, Clarisse Gins, Marie Hully, et al.. Neuroinflammatory Disease following Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children. The Journal of Pediatrics, 2022, 247, pp.22-28.e2. ⟨10.1016/j.jpeds.2022.05.018⟩. ⟨hal-03941125⟩
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