Abstract Details

Neurological manifestations have been reported both in adults and children with coronavirus disease 2019 (COVID-19). Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2 (PIMS-TS) is a recently described severe post-infectious immune-mediated disorder.

Our aim was to report neurological manifestations of children with Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2 (PIMS-TS)

Patients (<18yrs) presenting to Great Ormond Street Hospital between March 1, 2020, and June 21, 2020 fulfilling PIMS-TS criteria, were included. Clinical and paraclinical features were retrieved retrospectively from electronic patient records.

Data was available for 45 patients who presented during the study period. Median age was 10.1 years (IQR 8.8, 13.5), 29 (64.4%) were male and 37 (82.2%) were of non-white ethnicities. New-onset neurological symptoms were reported in 23/45 (51.1%); headaches (n=16), encephalopathy (n=7), dysarthria/dysphonia (n=6), hallucinations (n=4), ataxia (n=4), peripheral nerve involvement (n=3), and seizures (n=1). One patient had 118 leukocytes in CSF. Splenium signal changes were seen in all 4/14 patients on brain MRI. A mild excess of slow activity was found in 10/10 who had an EEG and mild myopathic and neuropathic changes were seen 4/5 who underwent nerve conduction studies and electromyography. Children with neurological involvement had higher peak inflammatory markers and were more likely to be ventilated and require inotropic support in PICU (p less than 0.05).

Children with PIMS-TS presented with new neurological symptoms involving both the central and peripheral nervous systems, in the absence of respiratory symptoms. Neurological symptoms were seen more frequently in more severe presentations.