Neurological manifestations associated with SARS-CoV-2 infection in pediatric patients: a systematic review.

OBJECTIVE

To conduct a systematic review to identify neurological symptoms associated with SARS-CoV-2 in patients aged zero to 19 years, highlighting the main symptoms and addressing the existing gap in age range coverage in current studies.

DATA SOURCE: This study was registered in the International Prospective Register of Systematic Reviews - PROSPERO (CRD42024520151) and adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA (2020) guidelines. Observational and interventional studies, including randomized clinical trials, investigating neurological manifestations in children and adolescents with confirmed SARS-CoV-2 infection were included. Searches were conducted in the United States National Library of Medicine/Medical Literature Analysis and Retrieval System Online (PubMed/MEDLINE), Cochrane Library, and Virtual Health Library (VHL) using Health Science Descriptors/Medical Subject Headings (DeCS/MeSH) terms in English, Spanish, and Portuguese, covering January 2020 to January 2024.

DATA SYNTHESIS: The search identified 1283 records, of which 302 were excluded (outside of scope), 688 were removed after title/abstract screening, and 95 duplicates were discarded. Fulltext analysis of 198 articles resulted in the selection of 25 eligible studies. The most frequently reported neurological manifestations included seizures, headache, altered levels of consciousness, olfactory and gustatory disturbances, encephalopathy, and acute cerebrovascular diseases.

CONCLUSIONS

Neurological manifestations of COVID-19 in children are relatively common, ranging from mild symptoms such as headache and taste/smell disturbances to severe complications like seizures, stroke, altered consciousness, and encephalopathy. Prevalence varies across studies, underscoring the need for further research to clarify underlying mechanisms.