artículo
Pediatric Ischemic Stroke: An Infrequent Complication of SARS-CoV-2
Fecha
2021Registro en:
10.1002/ana.25991
15318249
15318249 03645134
33332607
SCOPUS_ID:85099906288
WOS:000612581600001
Autor
Beslow, Lauren A.
Linds, Alexandra B.
Dlamini N.
Fox, Christine K.
Kossorotoff, Manoëlle
Zuñiga Zambrano, Yenny C.
Hernández Chavez, Marta Isabel
Hassanein, Sahar .M.A.
Byrne, Susan
Lim, Ming
Maduaka, Nkechi
Zafeiriou, Dimitrios
Dowling, Michael M.
Felling, Ryan J.
Rafay, Mubeen F.
Lehman, Laura L.
Noetzel, Michael J.
Bernard, Timothy J.
Dlamini, Nomazulu
Institución
Resumen
© 2020 American Neurological AssociationObjective: 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 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;89:657–665.