Posters

Presenting Author

Nelson D. Gonzalez

Presentation Type

Poster

Discipline Track

Clinical Science

Abstract Type

Case Report

Abstract

Background: Neurologic complications of COVID-19 in the pediatric population have been reported in a limited number of reports. There have been reports of COVID-19-associated encephalitis in pediatric cases along with neuroimaging findings revealing involvement of some parts of the nervous system. We present the first case of pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - associated encephalitis targeting the parietal lobes.

Case: A 14-year-old morbidly obese Hispanic male with no past medical history presented to the hospital for new onset seizures. Family reported exposure to his COVID-19 positive mother, a one-week history of fever, and a three-month history of decreased oral intake, vomiting, diarrhea, weight loss, and decreased urine output. He tested positive for SARS CoV-2 six days prior to admission. Patient was admitted to the intensive care unit. Blood pressure was 169/101. Labs included elevated blood urea nitrogen and creatinine, 102mg/dL and 26 mg/dL, respectively, consistent with severe kidney injury. Brain MRI revealed restricted diffusion on the bilateral subcortical white matter of the parietal lobes. Electroencephalogram revealed mild to moderate encephalopathy. After treatment with convalescent plasma and dexamethasone there was complete neuroradiologic abnormality resolution with dramatic clinical improvement.

Conclusions: This case highlights a new brain target of the SARS-CoV-2 in pediatric patients. The temporal improvement in symptoms after administration of convalescent plasma and dexamethasone raises interest in their use for management of SARS-COV-2 infection in pediatric patients. Further research into these findings is important for predominately Hispanic communities which have been disproportionately affected by the pandemic.

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Pediatric COVID-19 Encephalitis

Background: Neurologic complications of COVID-19 in the pediatric population have been reported in a limited number of reports. There have been reports of COVID-19-associated encephalitis in pediatric cases along with neuroimaging findings revealing involvement of some parts of the nervous system. We present the first case of pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - associated encephalitis targeting the parietal lobes.

Case: A 14-year-old morbidly obese Hispanic male with no past medical history presented to the hospital for new onset seizures. Family reported exposure to his COVID-19 positive mother, a one-week history of fever, and a three-month history of decreased oral intake, vomiting, diarrhea, weight loss, and decreased urine output. He tested positive for SARS CoV-2 six days prior to admission. Patient was admitted to the intensive care unit. Blood pressure was 169/101. Labs included elevated blood urea nitrogen and creatinine, 102mg/dL and 26 mg/dL, respectively, consistent with severe kidney injury. Brain MRI revealed restricted diffusion on the bilateral subcortical white matter of the parietal lobes. Electroencephalogram revealed mild to moderate encephalopathy. After treatment with convalescent plasma and dexamethasone there was complete neuroradiologic abnormality resolution with dramatic clinical improvement.

Conclusions: This case highlights a new brain target of the SARS-CoV-2 in pediatric patients. The temporal improvement in symptoms after administration of convalescent plasma and dexamethasone raises interest in their use for management of SARS-COV-2 infection in pediatric patients. Further research into these findings is important for predominately Hispanic communities which have been disproportionately affected by the pandemic.

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