• J Formos Med Assoc · Mar 2024

    High incidence of cerebrovascular lesions on magnetic resonance imaging in pediatric COVID-19 during omicron outbreak - A retrospective case series.

    • Yen-Ju Chu, Lee-Chin Wong, Wen-Chin Weng, Pi-Chuan Fan, Hsin-Pei Wang, Yung-Ting Kuo, Ting-Yu Yen, Chun-Yi Lu, Ping-Ing Lee, Luan-Yin Chang, Ching-Chia Wang, En-Ting Wu, Frank Leigh Lu, Steven Shinn-Forng Peng, and Wang-Tso Lee.
    • Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
    • J Formos Med Assoc. 2024 Mar 1.

    BackgroundThe incidence of pediatric hospitalizations has significantly increased since the spread of the omicron variant of COVID-19. Changes of characteristics in respiratory and neurological symptoms have been reported. We performed a retrospective, cross-sectional study to characterize the MRI change in children with an emphasis on the change of cerebral vasculatures.MethodsWe retrospectively collected clinical and MRI data of 31 pediatric patients with neurological symptoms during the acute infection and abnormalities on MRI during the outbreak of omicron variant from April 2022 to June 2022 in Taiwan. The clinical manifestations and MRI abnormalities were collected and proportion of patients with vascular abnormalities was calculated.ResultsAmong 31 pediatric patients with post-COVID-19 neurological symptoms, MRI abnormalities were observed in 15 (48.4%), predominantly encephalitis/encephalopathy (73.3%). Notable MRI findings included focal diffusion-weighted imaging (DWI) hyperintensity in cerebral cortex and thalamus, diffuse cortical T2/DWI hyperintensity, and lesions in the medulla, pons, cerebellum, and splenium of corpus callosum. Vascular abnormalities were seen in 12 (80%) patients with MRI abnormalities, mainly affecting the middle cerebral arteries. The spectrum of neurological manifestations ranged from seizures to Alice in Wonderland syndrome, underscoring the diverse impact of COVID-19 on pediatric patients.ConclusionA high proportion of vascular abnormalities was observed in pediatric patients with neurological involvements, suggesting that vascular involvement is an important mechanism of neurological manifestations in omicron variant infection.Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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