A critical appraisal of neurological evidence on paediatric COVID-19 patients. A systematic literature review

Objective: The aim of our study was to assess the close direct relationship between the development of neurological manifestations and SARS-CoV-2 infection in paediatric patients, by a systematic review of the literature.Methods: PubMed and Google Scholar were searched for publications from the start of the pandemic up to 31 December 2022. We included articles that described nervous system manifestations in patients aged 0-18 years with RT-PCR nasopharyngeal swab positivity for SARSCoV-2.Results: The initial search produced 3456 records, of which 37, involving a total of 48 paediatric patients, were included in our systematic review. The neurological complications were heterogeneous, due at least in part to the different age groups considered. In the literature, encephalitis was the most common diagnosis (20.83%). Clinical presentation, diagnostic support, treatment and outcome were analysed both in the literature and in our experience.Conclusions: Neurological impairment can occur with the first clinical presentation of COVID-19, even in previously healthy children and with mild forms of the disease. The clinical presentations are heterogeneous in the different age groups. In most patients the outcome is good and neurological manifestations subside after discharge.

Automated summary

The objective of this study was to evaluate the close relationship between neurological manifestations and SARS-CoV-2 infection in pediatric patients through a systematic review. PubMed and Google Scholar were searched for literature published from the start of the pandemic until December 31, 2022. A total of 37 articles involving 48 pediatric patients were included in the review, and the neurological complications were found to be heterogeneous, possibly due to different age groups. The majority of patients had a good outcome, with neurological symptoms subsiding after discharge.