Neurological Manifestations in Pediatric Patients Hospitalized for COVID-19: Experiences of the National Medical Center “20 de Noviembre” in Mexico City
Brian Javier López-Pérez,
Diana Alejandra Cruz-Chávez,
Elsa Solórzano-Gómez,
José Antonio Venta-Sobero,
Iván Alejandro Tapia-García,
Christian Gabriel Toledo-Lozano,
Andrea Torres-Vallejo,
Gabriela Vianney Castro-Loza,
Yazmín Evelyn Flores-Jurado,
Cristal Lucero Hernández-Soriano,
Sofía Lizeth Alcaraz-Estrada,
Paul Mondragón-Terán,
Juan Antonio Suárez-Cuenca,
Silvia Garcia
Affiliations
Brian Javier López-Pérez
Department of Pediatric Neurology, Centro Médico Nacional “20 de Noviembre”, ISSSTE, Mexico City 03229, Mexico
Diana Alejandra Cruz-Chávez
Department of Pediatric Neurology, Centro Médico Nacional “20 de Noviembre”, ISSSTE, Mexico City 03229, Mexico
Elsa Solórzano-Gómez
Department of Pediatric Neurology, Centro Médico Nacional “20 de Noviembre”, ISSSTE, Mexico City 03229, Mexico
José Antonio Venta-Sobero
Department of Pediatric Neurology, Centro Médico Nacional “20 de Noviembre”, ISSSTE, Mexico City 03229, Mexico
Iván Alejandro Tapia-García
Department of Pediatric Infectology, Centro Médico Nacional “20 de Noviembre”, ISSSTE, Mexico City 03229, Mexico
Christian Gabriel Toledo-Lozano
Department of Clinical Research, Centro Médico Nacional “20 de Noviembre”, ISSSTE, Mexico City 03229, Mexico
Andrea Torres-Vallejo
Department of Pediatric Endocrinology, Instituto Nacional de Pediatría, Mexico City 03700, Mexico
Gabriela Vianney Castro-Loza
Department of Urdergraduate Research, Hospital Militar de Especialidades de la Mujer y Neonatología, Mexico City 11200, Mexico
Yazmín Evelyn Flores-Jurado
Department of Pediatric Neurology, Centro Médico Nacional “20 de Noviembre”, ISSSTE, Mexico City 03229, Mexico
Cristal Lucero Hernández-Soriano
Department of Pediatric Neurology, Centro Médico Nacional “20 de Noviembre”, ISSSTE, Mexico City 03229, Mexico
Sofía Lizeth Alcaraz-Estrada
Department of Genomic Medicine, Centro Médico Nacional “20 de Noviembre”, ISSSTE, Mexico City 03229, Mexico
Paul Mondragón-Terán
Department of Clinical Research, Centro Médico Nacional “20 de Noviembre”, ISSSTE, Mexico City 03229, Mexico
Juan Antonio Suárez-Cuenca
Department of Clinical Research, Centro Médico Nacional “20 de Noviembre”, ISSSTE, Mexico City 03229, Mexico
Silvia Garcia
Department of Clinical Research, Centro Médico Nacional “20 de Noviembre”, ISSSTE, Mexico City 03229, Mexico
COVID-19 has affected millions of children and, while it was previously considered as a respiratory disease, neurologic involvement has also been documented. The objective of this study was to identify the neurological manifestations (NMs) and the outcomes of children with COVID-19 who attended the National Medical Center “20 de Noviembre”. Methods: A retrospective cohort study of children hospitalized for COVID-19 from April 2020 to March 2021 was conducted. Clinical-demographic data were registered. Neurologic manifestations were defined as any clinical neurological expression of the central and/or peripheral nervous system that occurred during admission or hospitalization. Results: In total, 46 children with a confirmed COVID-19 result, 26 (56.5%) boys and 20 (43.5%) girls with a median age of 8.9 ± 4.6 years, constituted the study population. Half of the children showed some NMs, and this group of patients concomitantly showed acute lymphoblastic leukemia (ALL, 56%), obesity (17.3%), or acute myeloblastic leukemia (AML, 4.3%). The most frequently described NMs were headache (13, 56%), encephalopathy (10, 43.47%), and epilepsy (4, 17.39%). The mortality rate in children with NMs was 21.7% and they had a higher mortality rate when compared to those without NM p ≤ 0.025. Conclusions: NMs occurred predominantly in male children aged 6 to 12 years; ALL was the most frequent comorbidity. Headache prevailed and hypoxemia, hypocalcemia, elevated ferritin, and C-reactive protein were associated with NM. Finally, NMs were a risk factor for mortality.