Clinico-Radiological Profile of The Spectrum and Diverse Neurological Manifestations of Covid-19 Infection In Children From A Teritiary Care Centre - A Prospective Observational Study

OBJECTIVES The global impact of the novel SARS-COVID -19 on pediatric population has been analysed extensively, nonetheless the literature on diversity of its neurological spectrum is scant. This study aims to elucidate various demographic ,clinical ,radiological ,management and outcome attributes of diverse neurological presentations in children with covid-19 infection METHODS Prospective observational study done from a single tertiary-care centre across 2 years (March 2020- February 2022).Patients under 18 years with neurological complications of Covid-19 infection were included. RESULTS A total of 57 patients were enrolled (positive RT-PCR in 18 and Covid-19 antibodies in 39) and their mean age of presentation was 7.2 years (M:F=2.3:1).The most frequent clinical presentation was encephalopathy (57%), followed by seizures(45%).The spectrum of other neurological manifestations and their fraction is depicted in figure 1. WHO diagnostic criteria of MIS-C was met in 25 patients. AbnormaI findings on EEG ,CSF analysis and MRI were seen in 12/20,6/20 and 20/45 patients respectively. Diverse clinical presentations were isolated encephalopathy, Covid encephalitis, febrile seizures, isolated cranial nerve palsies, MERS, stroke and ANEC. Management was tailored based on the diagnosis and severity with steroids, IVIG, Aspirin and Enoxaparin .Short term-3-month follow-up outcomes were good in all the cases except for 2 mortalities and 4 residual focal neuro-deficits. Statistical analysis of all the parameters comparing MISC and non-MISC cases was done. CONCLUSION This study obtained robust estimates of several key epidemiological ,clinical ,radiological ,treatment and outcome parameters of Covid-19 associated neurological disease ,which provides an additional evidence to the current literature