Children with the Covid-19 illness can be affected with varying degrees of severity, ranging from asymptomatic to mild, moderate, severe or critical illness. While symptoms such as fever, cough, cold, nausea, vomiting, and loose stools are common, some neurological and psychological effects can also occur. These could include fits/seizures of varying duration and severity, weakness in the limbs, impaired consciousness, or even stroke. In these severe cases, the child may require hospitalisation in a paediatric intensive care facility, hence it is important to be aware and seek help early. If any of the following symptoms are observed, parents must seek expert guidance immediately.
The following are some that have been observed:
ENCEPHALOPATHY
This is a condition when a virus infection attacks the brain and is commonly called brain fever. A child can have altered sensorium, be excessively sleepy or irritable. Such a child may need advanced life support such as ventilation and care in a specialist pediatric intensive care setup. The duration and severity of involvement of the brain are variable and could be life-threatening.
SEIZURES
Seizures or fits are rhythmic jerking of limbs, up-rolling of eyes. It can last for a few minutes to hours, usually due to abnormal uncontrolled electrical signals in the brain. Children may or may not have associated symptoms of Covid illness. Children with known seizures that are well controlled, can have a breakthrough or fresh seizures related to Covid illness. Such children need to be stabilised in the Emergency Department and may need further care in a specialist Pediatric intensive care unit.
HYPOSMIA AND HYPOGEUSIA
The lack or decreased ability to smell is known as Hyposmia. The olfactory receptors are affected in this condition. A loss of sensation of taste or smell was commonly reported as a Covid symptom. It is prudent to watch for similar signs in our children.
STROKE
A stroke is a medical emergency in which the brain is unable to get an adequate supply of oxygen, due to blockage due to a clot in the blood supply to the brain resulting in a lack of consciousness, headache, and other serious conditions.
GUILLAIN–BARRÉ SYNDROME
GBS is another commonly recorded syndrome that affects Covid patients. This is an autoimmune condition where the body attacks its own nervous system. It has been very commonly observed in adults and can affect children as well. Symptoms of this could be a weakness in the body, loss or reduced sensation in feet and hands, some degree of muscle paralysis and pain, an inability to swallow properly.
ORBITAL CELLULITIS WITH INTRACRANIAL EXTENSION
A few cases of Covid-19 have also reported Orbital Cellulitis along with Intracranial Extension. This is a condition where there is swelling in the area near your eye due to a bacterial infection. If the child is experiencing this in addition to symptoms such as dry cold, tiredness, sore throat, headache, skin rashes, difficulty in breathing, loss of speech, chest pain, etc, it could be a Covid-caused complication.
The writer is Sr. Consultant and Lead PICU, Aster RV Hospital.
