Neurological and Pulmonary Radiological Abnormalities of Corona Virus Disease 2019, Are They Different between Adult and Pediatric Patients? Observational Study

Abstract Background: Corona virus disease-2019 (COVID-19) became a world pandemic causing millions of deaths world-wide. Adults and pediatrics can be infected. Corona virus disease-2019 affects different body organs including central nervous system not only lung. Aim of Study: This study aimed to describe the imaging findings of corona virus neurological and pulmonary compli-cations developed in infected adults and pediatrics. The two groups were observed regarding the possible pathophysiology, radiological findings, mean computed tomography (CT) chest severity score and clinical outcome. Patients and Methods: This observational study included 50 patients 36 were adults and 14 were pediatrics. Only patients with positive COVID-19 polymerase chain reaction tests, who presented with neurological complications were included. All patients were examined by CT chest, different neuroimaging modalities were used according to patient's neurological presentations. CT chest was assessed for extent of ground glass or consolidative patches to obtain CT severity score. The neurological complications detected were classified according to the possible underlying pathophysiology into: A-complications due to: (A) Cerebro-vascular diseases, (B) Auto immune mechanisms and (C) Direct virus effect. Results: The neurological complications detected in adults were mainly due to A-cerebro vascular diseases: Stroke seen in 44.4% of patients followed by sinus thrombosis in 25%, then intracranial hemorrhage in 19.4%, followed by B-auto immune mechanisms totally seen in 30.55% of patients and less frequently due to C-direct virus effect: As anosmia seen in 11.1 % of patients. While in pediatrics, the neurological diseases detected were only due to autoimmune mechanism seen in 100% of patients. The mean CT severity score was higher in adults (7.36) compared to pediatrics (5.21). In the adult group 54.8% of patients were improved up to total recovery of presenting neurological symptoms and signs, while the percent was higher in the pediatric group 85.7% indicating better clinical outcome in pediatrics.
Conclusion: COVID-19 associated neurological abnor-malities showed an increased prevalence among both adult and pediatric patients. The pattern and possible pathophysiol-ogy of neurological affection differed between both groups but pediatric patients showed a better clinical outcome.