Pediatric Ischemic Stroke: An Infrequent Complication of SARS-CoV-2

被引：78

作者：

Beslow, Lauren A. ^{[1
,2
]}

Linds, Alexandra B. ^{[3
,4
]}

Fox, Christine K. ^{[5
,6
]}

Kossorotoff, Manoelle ^{[7
]}

Zuniga Zambrano, Yenny C. ^{[8
]}

Hernandez-Chavez, Marta ^{[9
]}

Hassanein, Sahar M. A. ^{[10
]}

Byrne, Susan ^{[11
,12
]}

Lim, Ming ^{[11
,13
]}

Maduaka, Nkechi ^{[14
]}

Zafeiriou, Dimitrios ^{[15
]}

Dowling, Michael M. ^{[16
,17
]}

Felling, Ryan J. ^{[18
]}

Rafay, Mubeen F. ^{[19
]}

Lehman, Laura L. ^{[20
]}

Noetzel, Michael J. ^{[21
,22
]}

Bernard, Timothy J. ^{[23
,24
]}

Dlamini, Nomazulu ^{[3
,4
,25
]}

机构：

[1] Univ Penn, Div Neurol, Childrens Hosp Philadelphia, Dept Neurol,Perelman Sch Med, Philadelphia, PA 19104 USA

[2] Univ Penn, Div Neurol, Childrens Hosp Philadelphia, Dept Pediat,Perelman Sch Med, Philadelphia, PA 19104 USA

[3] Hosp Sick Children, Dept Paediat, Div Neurol, Toronto, ON, Canada

[4] Hosp Sick Children, Child Hlth Evaluat Sci Program, Toronto, ON, Canada

[5] Univ Calif San Francisco, Dept Neurol, San Francisco, CA USA

[6] Univ Calif San Francisco, Dept Pediat, San Francisco, CA USA

[7] Univ Hosp Necker Enfants Malad, APHP, French Ctr Pediat Stroke, Pediat Neurol Dept, Paris, France

[8] Hosp Misericordia, Pediat Neurol Unit, Bogota, Colombia

[9] Pontificia Univ Catolica Chile, Neurol Unit, Div Pediat, Sch Med, Santiago, Chile

[10] Ain Shams Univ, Dept Pediat, Fac Med, Cairo, Egypt

[11] Evelina London Childrens Hosp, London, England

[12] Royal Coll Surg, FutureNeuro, Dublin, Ireland

[13] Kings Coll London, Fac Life Sci & Med, London, England

[14] Kings Coll Hosp London, Dept Paediat, London, England

[15] Aristotle Univ Thessaloniki, Hippokratio Gen Hosp, Dept Pediat, Thessaloniki, Greece

[16] Univ Texas Southwestern Med Ctr Dallas, Dept Pediat, Dallas, TX USA

[17] Univ Texas Southwestern Med Ctr Dallas, Dept Neurol, Dallas, TX USA

[18] Johns Hopkins Sch Med, Dept Neurol, Baltimore, MD USA

[19] Univ Manitoba, Dept Pediat & Child Hlth, Neurol Sect, Childrens Hosp Res Inst Manitoba, Winnipeg, MB, Canada

[20] Harvard Med Sch, Boston Childrens Hosp, Dept Neurol, Boston, MA 02115 USA

[21] Washington Univ, St Louis Childrens Hosp, Dept Neurol, Div Pediat & Dev Neurol,Sch Med,Neurorehabil Prog, St Louis, MO 63110 USA

[22] Washington Univ, St Louis Childrens Hosp, Dept Pediat, Div Pediat & Dev Neurol,Sch Med,Neurorehabil Prog, St Louis, MO 63110 USA

[23] Univ Colorado, Sect Child Neurol, Childrens Hosp Colorado, Dept Pediat,Hemophilia & Thrombosis Ctr,Sch Med, Aurora, CO USA

[24] Univ Colorado, Sect Child Neurol, Childrens Hosp Colorado, Dept Neurol,Hemophilia & Thrombosis Ctr,Sch Med, Aurora, CO USA

[25] Univ Toronto, Dept Pediat, Toronto, ON, Canada

来源：

ANNALS OF NEUROLOGY | 2021年 / 89卷 / 04期

关键词：

CHILDHOOD; VACCINATION; INFECTION; CHILDREN;

D O I：

10.1002/ana.25991

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective Severe complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) include arterial ischemic stroke (AIS) in adults and multisystem inflammatory syndrome in children. Whether stroke is a frequent complication of pediatric SARS-CoV-2 is unknown. This study aimed to determine the proportion of pediatric SARS-CoV-2 cases with ischemic stroke and the proportion of incident pediatric strokes with SARS-CoV-2 in the first 3 months of the pandemic in an international cohort. Methods We surveyed 61 international sites with pediatric stroke expertise. Survey questions included: numbers of hospitalized pediatric (<= 18 years) patients with SARS-CoV-2; numbers of incident neonatal and childhood ischemic strokes; frequency of SARS-CoV-2 testing for pediatric patients with stroke; and numbers of stroke cases positive for SARS-CoV-2 from March 1 to May 31, 2020. Results Of 42 centers with SARS-CoV-2 hospitalization numbers, 8 of 971 (0.82%) pediatric patients with SARS-CoV-2 had ischemic strokes. Proportions of stroke cases positive for SARS-CoV-2 from March to May 2020 were: 1 of 108 with neonatal AIS (0.9%), 0 of 33 with neonatal cerebral sinovenous thrombosis (CSVT; 0%), 6 of 166 with childhood AIS (3.6%), and 1 of 54 with childhood CSVT (1.9%). However, only 30.5% of neonates and 60% of children with strokes were tested for SARS-CoV-2. Therefore, these proportions represent 2.9, 0, 6.1, and 3.0% of stroke cases tested for SARS-CoV-2. Seven of 8 patients with SARS-CoV-2 and stroke had additional established stroke risk factors. Interpretation As in adults, pediatric stroke is an infrequent complication of SARS-CoV-2, and SARS-CoV-2 was detected in only 4.6% of pediatric patients with ischemic stroke tested for the virus. However, < 50% of strokes were tested. To understand the role of SARS-CoV-2 in pediatric stroke better, SARS-CoV-2 testing should be considered in pediatric patients with stroke as the pandemic continues. ANN NEUROL 2021

引用

页码：657 / 665

页数：9

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