The Impact of COVID-19 in Children

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Infectious Diseases".

Deadline for manuscript submissions: closed (20 November 2022) | Viewed by 21339

Special Issue Editor

Pediatric Anesthesia and Intensive Care, Ospedale dei Bambini Vittore Buzzi, Milano, Italy
Interests: pediatric intensive care; pediatric anesthesia; pediatric vascular access; pediatric emergencies; point-of-care ultrasound; pediatric echocardiography; pediatric lung ultrasound
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Special Issue Information

Dear Colleagues,

At the beginning of the COVID-19 pandemic, there were high hopes that it would spare our children; however, it quickly became evident that this would not be the case. Although they are ill less frequently than adults, children have been affected by the virus and its manifestations vary—acute pulmonary infection, multisystem inflammatory syndrome in children (MIS-C), and long COVID-19 are only some of the multiple features of COVID-19 in children.

However, aside from these clinical manifestations, COVID-19 has impacted our children’s health in other profound ways, such as the impact of school closures and isolation on mental health, to cite one, or the delayed access to care for many diseases and their consequences.

In this Special Issue of Children, we would like to collect papers on all the manifestations of COVID-19 and their impact on our children’s health, two years after the beginning of the pandemic.

Dr. Anna Camporesi
Guest Editor

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Keywords

  • COVID-19
  • multisystem inflammatory syndrome in children (MIS-C)
  • long COVID-19 in children
  • children
  • school closures
  • children and adolescents’ mental health
  • isolation
  • change in viral diffusion

Published Papers (13 papers)

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Editorial

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4 pages, 167 KiB  
Editorial
COVID-19 and Children: Reflections after Three Years
by Anna Camporesi, Luigi Vetrugno and Danilo Buonsenso
Children 2024, 11(1), 10; https://doi.org/10.3390/children11010010 (registering DOI) - 21 Dec 2023
Viewed by 754
Abstract
Three years after the beginning of the COVID-19 pandemic, enough experience has been gained to derive reflections on the impact of SARS-CoV-2 in children [...] Full article
(This article belongs to the Special Issue The Impact of COVID-19 in Children)

Research

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10 pages, 1896 KiB  
Article
Respiratory Syncytial Virus Outbreak in Infants and Young Children during COVID-19 Pandemic in Taiwan
by Hsin Chi and Ching-Hu Chung
Children 2023, 10(4), 629; https://doi.org/10.3390/children10040629 - 28 Mar 2023
Cited by 1 | Viewed by 1770
Abstract
Respiratory syncytial virus (RSV) is a major burden of disease in babies and young children, including hospitalizations and deaths. RSV is a seasonal disease that peaks when temperatures decrease in temperate zones and humidity increases in tropical regions. Existing research reveals that RSV [...] Read more.
Respiratory syncytial virus (RSV) is a major burden of disease in babies and young children, including hospitalizations and deaths. RSV is a seasonal disease that peaks when temperatures decrease in temperate zones and humidity increases in tropical regions. Existing research reveals that RSV hospitalization activity is year-round in Taiwan, which is a subtropical region with small peaks in spring and fall. The monthly distribution and COVID-19 pandemic impact were unclear. The aim of this study was to investigate Taiwan’s RSV hospitalization seasonality and the COVID-19 pandemic effects. The National Health Insurance Database and Death Registration Files from the Center for Health and Welfare Data Science Center were connected to birth data for this study. RSV hospitalization (RSVH) in infants aged 0–1 years ranged from 0.9518% (2009) to 1.7113% (2020), substantially higher than in children aged 1–5. Most years had 2 or 3 RSV epidemic seasons in 0–5-year-olds over the 13-year follow-up. RSVH incidence was low until the autumn of 2020, when a major rise occurred after September and lasted until December 2020. We detected RSVH peaks in February–May and July–August. The 2020 RSV outbreak was found at the end of 2020. Full article
(This article belongs to the Special Issue The Impact of COVID-19 in Children)
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12 pages, 583 KiB  
Article
A Prospective Evaluation of the Effects of the COVID-19 Pandemic on Youth with Primary Headache Disorders
by Mark Connelly, Jennifer Dilts, Madeline Boorigie and Trevor Gerson
Children 2023, 10(2), 184; https://doi.org/10.3390/children10020184 - 19 Jan 2023
Viewed by 1230
Abstract
Alterations in certain academic and social/family routines during the COVID-19 pandemic have been speculated to be either a risk factor or buffer for poor health outcomes for youth with stress-sensitive health conditions such as primary headache disorders. The current study evaluated patterns and [...] Read more.
Alterations in certain academic and social/family routines during the COVID-19 pandemic have been speculated to be either a risk factor or buffer for poor health outcomes for youth with stress-sensitive health conditions such as primary headache disorders. The current study evaluated patterns and moderators of pandemic impacts on youth with primary headache disorders, with an aim of extending our understanding of the relationship between stress, resilience, and outcomes in this population. Children recruited from a headache clinic in the midwestern United States reported on their headaches, schooling, routines, psychological stress, and coping at four timepoints ranging from within a few months of the pandemic onset to a long-term follow-up 2 years later. Changes in headache characteristics over time were analyzed for association with demographics, school status, altered routines, and stress, and coping. At baseline, 41% and 58% of participants reported no change in headache frequency or intensity, respectively, relative to pre-pandemic levels, with the remainder almost equally divided between reporting an improvement or worsening. The results of multilevel growth model analyses indicated that headache intensity remained more elevated over time since the start of the pandemic for respondents whose stress scores were relatively higher (b = 0.18, t = −2.70, p = 0.01), and headache-related disability remained more elevated over time for older respondents (b = 0.01, t = −2.12, p = 0.03). The study results suggest, overall, that the outcomes of primary headache disorders in youth were not systematically altered by the COVID-19 pandemic. Full article
(This article belongs to the Special Issue The Impact of COVID-19 in Children)
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13 pages, 267 KiB  
Article
The Impact of the COVID-19 Pandemic on Lifestyle and Wellbeing of Children, Adolescents and Their Parents: A Qualitative Study
by Kelly G. H. van de Pas, Marijn L. Hesselink, Robin Schlechtriem, Lisanne Arayess, Johanna M. Kreutz and Anita C. E. Vreugdenhil
Children 2022, 9(12), 1929; https://doi.org/10.3390/children9121929 - 08 Dec 2022
Cited by 1 | Viewed by 1458
Abstract
Prior studies have shown that changes in daily structure and habits due to the COVID-19 pandemic affected the lifestyle and wellbeing of families. This study aimed to obtain in-depth information on children’s and adolescents’ experiences regarding their lifestyle and wellbeing during the pandemic. [...] Read more.
Prior studies have shown that changes in daily structure and habits due to the COVID-19 pandemic affected the lifestyle and wellbeing of families. This study aimed to obtain in-depth information on children’s and adolescents’ experiences regarding their lifestyle and wellbeing during the pandemic. Semi-structured interviews with fifteen families were carried out between May and November 2021. Directed content analysis was used to analyze the transcripts and fundamental qualitative description to describe the results. Children and adolescents revealed an overall unhealthier lifestyle and decreased wellbeing. These negative effects were even larger in adolescents and children with overweight or psychosocial complaints. Our results revealed that parents were actively involved in maintaining a normal daily structure. Furthermore, diet changes were inconsistent and dependent on food availability. An increase in screen time was experienced as inevitable, and external influences were necessary to keep children and adolescents active. Almost no effects were reported on physical health, whereas negative emotions were experienced in varying degrees. Moreover, the decrease in social interactions was reported as the most negative effect of the pandemic. The above-mentioned insights may contribute to the development of preventive measures to promote a healthy lifestyle and wellbeing of children and adolescents during future pandemics. Full article
(This article belongs to the Special Issue The Impact of COVID-19 in Children)
13 pages, 1275 KiB  
Article
Social, Academic and Health Status Impact of Long COVID on Children and Young People: An Observational, Descriptive, and Longitudinal Cohort Study
by Alba Gonzalez-Aumatell, Maria Victoria Bovo, Clara Carreras-Abad, Sara Cuso-Perez, Èlia Domènech Marsal, Roser Coll-Fernández, Aroia Goicoechea Calvo, Maria Giralt-López, Antonia Enseñat Cantallops, Sara Moron-Lopez, Javier Martinez-Picado, Paula Sol Ventura, Carlos Rodrigo and Maria Méndez Hernández
Children 2022, 9(11), 1677; https://doi.org/10.3390/children9111677 - 31 Oct 2022
Cited by 9 | Viewed by 2255
Abstract
There is a lack of evidence of the health impacts due to long COVID among children and young people (CYP). The objective of this study is to determine the main clinical characteristics of long COVID in CYP and to investigate the academic, social, [...] Read more.
There is a lack of evidence of the health impacts due to long COVID among children and young people (CYP). The objective of this study is to determine the main clinical characteristics of long COVID in CYP and to investigate the academic, social, and health status impacts of long COVID in this population. An observational, descriptive, and longitudinal study on CYP who presented COVID-19 symptoms for more than twelve weeks after SARS-CoV-2 infection was performed between December 2020 and May 2021. Fifty CYP were included, with a median age of 14.1 years, 33 (66%) were female, and 17 (34%) had a relative diagnosed with long COVID. Since the initial infection and up to the first visit, CYP had persisting symptoms for a median of 4.1 months, and for 18 (36%) CYP these symptoms persisted for more than 6 months. Fatigue (100%), neurocognitive disorders (74%), muscular weakness (74%), and headache (72%) were the most reported symptoms. A total of 9 (18%) CYP could not attend school, 17 (34%) had a reduced schedule, 33 (66%) showed a decreased school performance, and 68% had stopped extracurricular activities. This preliminary study shows the impact that long COVID has on the health, academic, and social life of CYP. Full article
(This article belongs to the Special Issue The Impact of COVID-19 in Children)
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13 pages, 701 KiB  
Article
The Attitudes of Children Undergoing Orthodontic Treatment toward Face Mask Wearing during the COVID-19 Pandemic: A Cross Sectional Study
by Jessica Olivia Cherecheș, Gabriela Ciavoi, Abel Emanuel Moca, Raluca Iurcov, Raluca Dima, Marius Bembea and Luminița Ligia Vaida
Children 2022, 9(7), 989; https://doi.org/10.3390/children9070989 - 01 Jul 2022
Viewed by 1426
Abstract
During the COVID-19 pandemic, the protective face mask has proven to be essential. The protective face masks cover the lower part of the face, including teeth and, for orthodontic patients, the orthodontic appliances. The aim of this study was to assess the impact [...] Read more.
During the COVID-19 pandemic, the protective face mask has proven to be essential. The protective face masks cover the lower part of the face, including teeth and, for orthodontic patients, the orthodontic appliances. The aim of this study was to assess the impact that the restrictive measures that were imposed during the COVID-19 pandemic and, especially, wearing a protective face mask had on a sample of Romanian children, and to compare the results previously obtained on a sample of Romanian teenagers with the results obtained after investigating children under the age of 12 years. The cross-sectional survey was conducted in two orthodontic offices from the city of Oradea, Romania. The study sample included children with ages between 8 and 11.9 years that were undergoing an orthodontic treatment with removable or fixed orthodontic appliances. After obtaining the results, comparisons were made with the answers provided by a group of adolescents previously investigated. The questionnaires consisted of 9 items that investigated children’ attitudes toward protective face mask wearing and other aspects related to the COVID-19 pandemic. Two hundred fifty-six children were included in the study (53.1% female patients, 46.9% male patients). Most of the children were not worried that face masks would hide their orthodontic appliances (Item 1—Never, 40.2%; Rarely, 28.9%) and did not consider that the necessity of face mask wearing negatively impacted their desire to undergo an orthodontic treatment, despite the fact that it covered the appliances (Item 2—Never, 37.1%; Rarely, 31.6%). However, 44.5% of children were not happy because they had to wear a face mask during the orthodontic treatment, considering the fact that it covered the orthodontic appliance (Item 6), and most patients (49.2%) did not want the face mask to continue to be mandatory (Item 7). Although children were not happy that they had to wear a face mask that covered the orthodontic appliances, protective face masks were generally well tolerated by Romanian children. Full article
(This article belongs to the Special Issue The Impact of COVID-19 in Children)
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15 pages, 302 KiB  
Article
On What Tasks Did Children between the Ages of 3 and 12 Years Spend Their Time during the COVID-19 Pandemic? An International Comparative Study between Ibero-America and Europe
by Alberto Sanmiguel-Rodríguez, Mª Luisa Zagalaz-Sánchez, Víctor Arufe-Giráldez, Javier Cachón-Zagalaz and Gabriel González-Valero
Children 2022, 9(7), 971; https://doi.org/10.3390/children9070971 - 29 Jun 2022
Viewed by 1299
Abstract
The pandemic caused by COVID-19 meant, in many countries, the establishment of a period of confinement in which families were forced to restrict movement and social contacts with the consequent risk of inactivity. Our objective as to analyze the degree of psychosocial well-being, [...] Read more.
The pandemic caused by COVID-19 meant, in many countries, the establishment of a period of confinement in which families were forced to restrict movement and social contacts with the consequent risk of inactivity. Our objective as to analyze the degree of psychosocial well-being, sociodemographic aspects and use of technological means depending on the educational level of the parents. The sample consisted of 2316 children aged between 3 and 12 years (M = 7.70; SD = 2.86). For the analysis and treatment of the data, the statistical software SPSS 25.0 (IBM Corp, Armonk, NY, USA) was used. We found that the European participants used more video consoles (M = 0.89 ± 1.33) and tablets (M = 1.30 ± 0.95), while the Ibero-Americans obtained higher values in the use of TV (M = 2.28 ± 1.10) and levels higher in a negative state of psychosocial well-being (M = 7.29 ± 1.07) and in tiredness/fatigue (M = 4.34 ± 2.44). We concluded that, during the period of confinement in European areas, higher values were obtained in the time dedicated to Physical Activity (PA), use of tablets, school task performance, artistic activities, family games, reading, free play and hours of sleep; while in Ibero-America, there were longer times in the use of technological devices and performing domestic tasks. Full article
(This article belongs to the Special Issue The Impact of COVID-19 in Children)
13 pages, 5529 KiB  
Article
Lung Ultrasound Patterns in Multisystem Inflammatory Syndrome in Children (MIS-C)-Characteristics and Prognostic Value
by Anna Camporesi, Marco Gemma, Danilo Buonsenso, Stefania Ferrario, Anna Mandelli, Matteo Pessina, Veronica Diotto, Elena Rota, Irene Raso, Laura Fiori, Alessandro Campari and Francesca Izzo
Children 2022, 9(7), 931; https://doi.org/10.3390/children9070931 - 21 Jun 2022
Cited by 3 | Viewed by 1482
Abstract
Objective and design: Following COVID-19 infection, children can develop an hyperinflammatory state termed Multisystem Inflammatory Syndrome in Children (MIS-C). Lung Ultrasound (LUS) features of COVID-19 in children have been described, but data describing the LUS findings of MIS-C are limited. The aim of [...] Read more.
Objective and design: Following COVID-19 infection, children can develop an hyperinflammatory state termed Multisystem Inflammatory Syndrome in Children (MIS-C). Lung Ultrasound (LUS) features of COVID-19 in children have been described, but data describing the LUS findings of MIS-C are limited. The aim of this retrospective observational study conducted between 1 March and 31 December 2020, at a tertiary pediatric hospital in Milano, is to describe LUS patterns in patients with MIS-C and to verify correlation with illness severity. The secondary objective is to evaluate concordance of LUS with Chest X-ray (CXR). Methodology: Clinical and laboratory data were collected for all patients (age 0–18 years) admitted with MIS-C, as well as LUS and CXR patterns at admission. PICU admission, needed for respiratory support and inotrope administration, hospital, and PICU length of stay, were considered as outcomes and evaluated in the different LUS patterns. An agreement between LUS and CXR evaluation was assessed with Cohen’ k. Results: 24 children, who had a LUS examination upon admission, were enrolled. LUS pattern of subpleural consolidations < or > 1 cm with or without pleural effusion were associated with worse Left Ventricular Ejection Fraction at admission and need for inotropes. Subpleural consolidations < 1 cm were also associated with PICU length of stay. Agreement of CXR with LUS for consolidations and effusion was slight. Conclusion: LUS pattern of subpleural consolidations and consolidations with or without pleural effusion are predictors of disease severity; under this aspect, LUS can be used at admission to stratify risk of severe disease. Full article
(This article belongs to the Special Issue The Impact of COVID-19 in Children)
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9 pages, 535 KiB  
Article
Out-of-Season Epidemic of Respiratory Syncytial Virus during the COVID-19 Pandemic: The High Burden of Child Hospitalization in an Academic Hospital in Southern Italy in 2021
by Daniela Loconsole, Francesca Centrone, Caterina Rizzo, Désirée Caselli, Azzurra Orlandi, Fabio Cardinale, Cristina Serio, Paola Giordano, Giuseppe Lassandro, Leonardo Milella, Maria Teresa Ficarella, Maria Elisabetta Baldassarre, Nicola Laforgia and Maria Chironna
Children 2022, 9(6), 848; https://doi.org/10.3390/children9060848 - 08 Jun 2022
Cited by 15 | Viewed by 3026
Abstract
Respiratory syncytial virus (RSV) infection is the most common cause of hospitalization in young children. In the last 2 years, public health measures aimed at controlling the spread of SARS-CoV-2 have affected the epidemiology and seasonality of RSV worldwide. The aim of this [...] Read more.
Respiratory syncytial virus (RSV) infection is the most common cause of hospitalization in young children. In the last 2 years, public health measures aimed at controlling the spread of SARS-CoV-2 have affected the epidemiology and seasonality of RSV worldwide. The aim of this descriptive retrospective observational study was to describe the characteristics of children hospitalized with RSV in an academic tertiary care hospital in Southern Italy in 2021. We also investigate the seasonal trends of RSV from 2017 to 2021. The demographic characteristics, comorbidities, clinical data, and coinfections were retrospectively evaluated. Compared with previous seasons, the 2021 outbreak of RSV was characterized by an increased number of patients, with a delayed peak observed in November. Overall, 179 children, including 128 (71.5%) aged <12 months, were hospitalized for RSV infection between August and December 2021. Ten children (5.6%) were admitted to the intensive care unit (ICU), all aged <5 months. One patient (0.5%) aged <1 month with severe comorbidities died. The severity of symptoms was significantly associated with younger age, underlying chronic disease, and the length of hospital stay (p < 0.05 each). History of prematurity was not significantly associated with the presence of coinfections. Because of the high burden of RSV infection and the expected larger RSV epidemics resulting from a greater number of RSV-naïve children, systematic epidemiological and virological surveillance is needed. Appropriate pathways for access to RSV prevention in all infants should also be introduced. Full article
(This article belongs to the Special Issue The Impact of COVID-19 in Children)
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Review

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14 pages, 235 KiB  
Review
Repercussions of COVID-19 Lockdown on Implementation of Children’s Rights to Education
by Nurul Hidayat Ab Rahman, Mohd Zamre Mohd Zahir and Nabeel Mahdi Althabhawi
Children 2023, 10(3), 474; https://doi.org/10.3390/children10030474 - 27 Feb 2023
Cited by 1 | Viewed by 1183
Abstract
Lockdowns were among the control measures taken by many countries to hinder the virus from rapidly spreading. Public places had to be closed, including schools, as children are among the vulnerable groups that must always be protected. The primary purpose of this article [...] Read more.
Lockdowns were among the control measures taken by many countries to hinder the virus from rapidly spreading. Public places had to be closed, including schools, as children are among the vulnerable groups that must always be protected. The primary purpose of this article is to explain children’s rights to education based on the Convention on the Rights of the Child (CRC) and the Sustainable Development Goals 2030 (SDG 2030). This article further investigates the consequences of COVID-19 lockdowns for ensuring that privilege for children. The article applies a qualitative method and observed that the lockdown strategy created challenges for all children with respect to receiving education, as the traditional learning pedagogy involving face-to-face meetings forcibly replaced by online learning. The principle of the best interest of the child is a primary consideration. In conclusion, governments must be responsible for providing all necessities to support education for all children, which is essential for human development. Full article
(This article belongs to the Special Issue The Impact of COVID-19 in Children)

Other

7 pages, 262 KiB  
Opinion
Nonspecific Effects of Infant Vaccines Make Children More Resistant to SARS-CoV-2 Infection
by Luis Fonte, María Ginori, Gissel García, Yisel Hernández, Yaxsier de Armas and Enrique J. Calderón
Children 2022, 9(12), 1858; https://doi.org/10.3390/children9121858 - 29 Nov 2022
Cited by 3 | Viewed by 918
Abstract
A myriad of reasons, or a combination of them, have been alluded to in order to explain the lower susceptibility of children to SARS-CoV-2 infection and the development of severe forms of COVID-19. This document explores an additional factor, still little addressed in [...] Read more.
A myriad of reasons, or a combination of them, have been alluded to in order to explain the lower susceptibility of children to SARS-CoV-2 infection and the development of severe forms of COVID-19. This document explores an additional factor, still little addressed in the medical literature related to the matter: nonspecific resistance to SARS-CoV-2 that could be generated by vaccines administered during childhood. The analysis carried out allows one to conclude that a group of vaccines administered during childhood is associated with a lower incidence and severity of SARS-CoV-2 infection among pediatric ages. Looking from an epidemiological perspective, this conclusion must be taken into consideration in order to ensure greater rationality in the design and implementation of prevention and control actions, including the administration of the COVID-19 vaccine, for these ages. Full article
(This article belongs to the Special Issue The Impact of COVID-19 in Children)
19 pages, 1171 KiB  
Systematic Review
Impacts of COVID-19 Restrictions on Young Children’s Outdoor Activity: A Systematic Review
by Junjie Liu, Shirley Wyver and Muhammad Chutiyami
Children 2022, 9(10), 1564; https://doi.org/10.3390/children9101564 - 16 Oct 2022
Cited by 4 | Viewed by 1859
Abstract
We sought to identify and synthesise available evidence to aid the understanding of the impact that COVID-19 restrictions had on the outdoor activity of children aged from birth to 12 years. Seven databases (Education Research Complete, ERIC, MEDLINE, PsycINFO, SPORTDiscus, Psychology and Behavioural [...] Read more.
We sought to identify and synthesise available evidence to aid the understanding of the impact that COVID-19 restrictions had on the outdoor activity of children aged from birth to 12 years. Seven databases (Education Research Complete, ERIC, MEDLINE, PsycINFO, SPORTDiscus, Psychology and Behavioural Sciences Collection, WHO COVID-19 Database) were searched for relevant journal articles in English published from 2020 on. Four qualitative and eleven quantitative studies were included after screening. JBI’s Critical Appraisal Tools were used for quality assessment. All qualitative studies showed an increase in outdoor activity. Less than half of the quantitative studies indicated an increase. Family demography, home characteristics, access to outdoor spaces, and parental support/encouragement/co-play were influential factors. The evidence also supports the recommendation for educators to increase children’s outdoor play time to adhere to the physical distancing guidance and sanitisation requirements. Limited evidence suggests that when COVID-19 restrictions led to decreased outdoor activity, it was associated with less peer socialisation. We identified significant gaps in understanding of the impact of COVID-19 restrictions on young children’s outdoor activity. Full article
(This article belongs to the Special Issue The Impact of COVID-19 in Children)
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10 pages, 1598 KiB  
Case Report
An Atypical Case of Aphasia: Transitory Ischemic Attack in a 13-Year-Old Patient with Asymptomatic SARS-CoV-2 Infection
by Marco Scaglione, Flavia Napoli, Giulia Prato, Mariasavina Severino, Marta Bertamino, Sara Signa and Mohamad Maghnie
Children 2022, 9(7), 983; https://doi.org/10.3390/children9070983 - 30 Jun 2022
Viewed by 1284
Abstract
We report the case of a 13-year-old patient, female, born in Northern Italy, who presented with an acute episode of aphasia, lasting about 15 min, accompanied by left arm dysesthesia. The state of consciousness remained preserved throughout the episode. After a first clinical [...] Read more.
We report the case of a 13-year-old patient, female, born in Northern Italy, who presented with an acute episode of aphasia, lasting about 15 min, accompanied by left arm dysesthesia. The state of consciousness remained preserved throughout the episode. After a first clinical evaluation at second-level hospital, the patient was sent to our institute for further investigations. Brain MRI performed at admission showed no noteworthy structural alterations. Electroencephalogram was not significant, as was the echocardiographic examination. ECG was normal, except for a corrected-QT at the upper limits of the normal range for age and gender. The neurological examination was substantially normal for the entire duration of the hospital stay. The symptomatology initially described has never reappeared. Blood tests were substantially negative, in particular thrombophilic screening excluded hereditary-familial thrombophilic diseases. Color doppler ultrasound of the supra-aortic trunks, splanchnic vessels and lower limbs were also normal. Only positivity to SARS-CoV-2 serology is reported. In the recent clinical history there were no symptoms attributable to symptomatic coronavirus infection. Full article
(This article belongs to the Special Issue The Impact of COVID-19 in Children)
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