Abnormal brain scans in children with COVID-19 revealed in data from 96 studies

As we have learned more about the SARS-CoV-2 virus over the past four years, we have discovered that far from being just a respiratory disease, COVID-19 can also affect many different body systems, including the brain. Despite the progress that has been made, we still have much to learn about the damage COVID-19 can cause, especially in children. A new study compiled brain scan data from nearly two years of scientific literature to try to summarize what we know so far.

From an initial search that yielded nearly 10,000 articles, the study authors narrowed them down to 96 for a comprehensive review, after excluding those that were unsuitable for reasons such as not containing appropriate imaging data or not focusing on pediatric COVID cases. The final set of articles contained data from 327 patients.

The data came from a wide range of countries in Asia, Europe and the Americas. Most of the imaging was obtained using magnetic resonance imaging (MRI), but some studies also used computed tomography (CT) or other methods.

The results showed that in children with COVID who show neurological symptoms, this can often be seen as a physical change in their brain.

“Our findings demonstrate that a substantial proportion of pediatric COVID-19 patients with neurological symptoms demonstrate abnormal neuroimaging findings, with 43.74 percent of children in the included studies demonstrating such abnormalities,” the authors write.

During the first wave of the pandemic, much of the reporting focused on the fact that children appeared to be at lower risk of serious illness than adults, something many found comforting at a time of extreme unrest and fear. Over time, this picture has become more nuanced. Although children can often recover more quickly from the infection, they are still at risk of complications and long-term COVID-19, as Yale pediatrician Dr. Carlos Oliveira explained to the World Health Organization.

In the study, the authors identified a range of different neurological symptoms in the children whose brains were scanned. One of the most common was encephalitis, or inflammation of the brain. This is a known complication of COVID-19, but efforts are still underway to find out how often it may occur. Some of the other findings included swelling, vascular abnormalities and inflammation of the spinal cord.

“The observed incidence of neurological abnormalities in pediatric COVID-19 patients carries several important clinical and research implications,” the authors summarize. “First, it emphasizes the need for a high index of suspicion for neurological complications in children with COVID-19, especially in children with neurological symptoms.”

“Second, the findings of this study highlight the importance of continued research into the long-term consequences of COVID-19 in children.”

The study has some limitations. For example, by defining their search period as starting in December 2019, the authors included research from the very early period of the pandemic, when relatively little was known about the virus. It is also difficult to say with certainty that imaging abnormalities are causally related to COVID-19 infection, as in some cases they may be caused by pre-existing conditions or medical procedures.

“These limitations underscore the need for future prospective studies that consider comorbidities and perform more complicated analyzes to confirm the potential association between COVID-19 and neuroimaging findings,” they conclude.

COVID-19 is no longer considered an emergency, but that doesn’t mean the pandemic is over. This research underlines the need for more and more research in our quest to fully understand what this virus can do.

The research has been published in Scientific Reports.

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