Neuroinflammatory Disease following Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children
Melodie Aubart
(1)
,
Charles-Joris Roux
(1)
,
Chloé Durrleman
(1)
,
Clarisse Gins
(1)
,
Marie Hully
(1)
,
Manoelle Kossorotoff
(1)
,
Cyril Gitiaux
(1)
,
Raphaël Levy
(1)
,
Florence Moulin
(1)
,
Agathe Debray
(1)
,
Zahra Belhadjer
(1)
,
Emilie Georget
(2)
,
Temi Kom
(3)
,
Philippe Blanc
(4)
,
Samer Wehbi
(5)
,
Mustapha Mazeghrane
(6)
,
Jeremie Tencer
(7)
,
Vincent Gajdos
(8)
,
Sebastien Rouget
(9)
,
Loic de Pontual
(10)
,
Romain Basmaci
(11)
,
Karima Yacouben
(12)
,
Francois Angoulvant
(13, 14)
,
Marianne Leruez-Ville
(1)
,
Delphine Sterlin
(15)
,
Flore Rozenberg
(16)
,
Matthieu Robert
(1)
,
Shen-Ying Zhang
(17)
,
Nathalie Boddaert
(1)
,
Isabelle Desguerre
(1)
1
Hôpital Necker - Enfants Malades [AP-HP]
2 CHIV - Centre Hospitalier Intercommunal Villeneuve-Saint-Georges
3 Hôpital Louis Pasteur [Chartres]
4 Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy]
5 CHV - Centre Hospitalier de Versailles André Mignot
6 CHI André Gregoire - Centre Hospitalier Intercommunal André Grégoire [Montreuil]
7 Hôpital Delafontaine
8 AP-HP - Hôpital Antoine Béclère [Clamart]
9 Centre Hospitalier Sud Francilien
10 Hôpital Jean Verdier [AP-HP]
11 Hôpital Louis Mourier - AP-HP [Colombes]
12 Hôpital Robert Debré Paris
13 HeKA - Health data- and model- driven Knowledge Acquisition
14 CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers
15 CHU Pitié-Salpêtrière [AP-HP]
16 Hôpital Cochin [AP-HP]
17 Rockefeller University [New York]
2 CHIV - Centre Hospitalier Intercommunal Villeneuve-Saint-Georges
3 Hôpital Louis Pasteur [Chartres]
4 Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy]
5 CHV - Centre Hospitalier de Versailles André Mignot
6 CHI André Gregoire - Centre Hospitalier Intercommunal André Grégoire [Montreuil]
7 Hôpital Delafontaine
8 AP-HP - Hôpital Antoine Béclère [Clamart]
9 Centre Hospitalier Sud Francilien
10 Hôpital Jean Verdier [AP-HP]
11 Hôpital Louis Mourier - AP-HP [Colombes]
12 Hôpital Robert Debré Paris
13 HeKA - Health data- and model- driven Knowledge Acquisition
14 CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers
15 CHU Pitié-Salpêtrière [AP-HP]
16 Hôpital Cochin [AP-HP]
17 Rockefeller University [New York]
Melodie Aubart
- Fonction : Auteur
- PersonId : 785446
- ORCID : 0000-0002-4383-7930
Cyril Gitiaux
- Fonction : Auteur
- PersonId : 768767
- ORCID : 0000-0002-2190-6843
- IdRef : 110494709
Romain Basmaci
- Fonction : Auteur
- PersonId : 1047428
- IdRef : 137467362
Résumé
Objective
To describe neurologic, radiologic and laboratory features in children with central nervous system (CNS) inflammatory disease complicating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Study design
We focused on CNS inflammatory diseases in children referred from 12 hospitals in the Paris area to Necker-Sick Children Reference Centre.
Results
We identified 19 children who had a history of SARS-CoV-2 infection and manifest a variety of CNS inflammatory diseases: encephalopathy, cerebellar ataxia, acute disseminated encephalomyelitis, neuromyelitis optica spectrum disorder, or optic neuritis. All patients had a history of SARS-CoV-2 exposure, and all tested positive for circulating antibodies against SARS-CoV-2. At the onset of the neurologic disease, SARS-CoV-2 PCR results (nasopharyngeal swabs) were positive in 8 children. Cerebrospinal fluid was abnormal in 58% (11/19) and magnetic resonance imaging was abnormal in 74% (14/19). We identified an autoantibody co-trigger in 4 children (myelin-oligodendrocyte and aquaporin 4 antibodies), representing 21% of the cases. No autoantibody was found in the 6 children whose CNS inflammation was accompanied by a multisystem inflammatory syndrome in children. Overall, 89% of patients (17/19) received anti-inflammatory treatment, primarily high-pulse methylprednisolone. All patients had a complete long-term recovery and, to date, no patient with autoantibodies presented with a relapse.
Conclusions
SARS2-CoV-2 represents a new trigger of postinfectious CNS inflammatory diseases in children.