Worldwide epidemiology of neuro-coronavirus disease in children: lessons for the next pandemic.
Worldwide epidemiology of neuro-coronavirus disease in children: lessons for the next pandemic.
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DOI：
10.1097/mop.0000000000001069
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发表时间：
2021-12-01
影响因子：
3.6
通讯作者：
Fink EL
中科院分区：
文献类型：
--
作者：
Alcamo AM;McGuire JL;Kanthimathinathan HK;Roa JD;Fink EL
严重急性呼吸综合征冠状病毒-2(SARS-CoV-2)大流行已使全球社会不堪重负，对患者健康和研究工作产生了负面影响；相关的神经症状是发病率的重要原因。该综述概述了不同临床表型的儿科SARS-CoV-2的神经系统表现的全球流行病学，包括急性冠状病毒病2019(新冠肺炎)、儿童多系统炎症综合征(MIS-C)和新冠肺炎急性后遗症(PASC)。我们讨论了为未来对新出现的儿科神经疾病的调查而开发适应性全球研究平台的策略。多中心、多国研究表明，急性新冠肺炎的神经系统表现，如嗅觉/味觉障碍、头痛和中风，在住院的成人(82%)和儿童(22%)中很常见，与成人死亡率增加有关。据报道，高达20%的儿童出现了MIS-C的神经学表现，包括头痛、易怒和脑病。有关PASC的数据正在浮现，包括疲劳、认知变化和头痛。由于缺乏儿科知情病例定义、通用数据元素和资源，对每种表型的神经学表现的报道受到限制。对儿童中与SARS-CoV-2相关的神经表现进行协调、资源充足的多国调查，对于快速确定全球和区域特有的风险因素，以及为当前的大流行和未来的健康神经紧急情况制定治疗和缓解战略至关重要。
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has overwhelmed the global community, negatively impacting patient health and research efforts; associated neurological manifestations are a significant cause of morbidity. This review outlines the worldwide epidemiology of neurologic manifestations of different SARS-CoV-2 clinical pediatric phenotypes, including acute coronavirus disease 2019 (COVID-19), multisystem inflammatory syndrome in children (MIS-C) and postacute sequelae of COVID-19 (PASC). We discuss strategies to develop adaptive global research platforms for future investigation into emerging pediatric neurologic conditions. Multicenter, multinational studies show that neurological manifestations of acute COVID-19, such as smell/taste disorders, headache, and stroke, are common in hospitalized adults (82%) and children (22%), associated with increased mortality in adults. Neurological manifestations of MIS-C are reported in up to 20% of children, including headache, irritability, and encephalopathy. Data on PASC are emerging and include fatigue, cognitive changes, and headache. Reports of neurological manifestations in each phenotype are limited by lack of pediatric-informed case definitions, common data elements, and resources. Coordinated, well resourced, multinational investigation into SARS-CoV-2-related neurological manifestations in children is critical to rapid identification of global and region-specific risk factors, and developing treatment and mitigation strategies for the current pandemic and future health neurologic emergencies.