abstract
- SARS2-CoV-2 represents a new trigger of the central nervous system (CNS) inflammatory diseases and neuropsychiatric manifestations in children and adolescents. Studies report neurologic involvement incidence that range from 4.8% to 66%: 40% of children with acute SARS-CoV-2, 25% with Long-COVID, and 66% with multisystem inflammatory syndrome (MIS-C) presented at least one neurological symptom. The most common neurological manifestations reported in children with acute COVID-19 were headache (16%), acute encephalopathy (15%), and seizures (8%). The most common neuroimaging finding was leptomeningeal contrast enhancement, suggesting neuritis, myelitis, and/or encephalomyelitis. Different hypotheses of mechanistic pathways have been described as causes of neurologic disease in COVID-19: - Direct viral invasion and replication in the CNS. - Vascular insufficiency (vasoconstriction, or clot occlusion). - Nonspecific effects of systemic viral illness or medication. - Immune system dysregulation. Long-term follow-up is necessary to define the future incidence of neurological and neuropsychiatric morbidity after SARS-CoV-2 infection, especially in children and adolescents. © 2025 Elsevier Inc. All rights are reserved.