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Brain magnetic resonance imaging findings in children with neurological complications of coronavirus disease 2019 (Omicron variant): a multicenter retrospective observational study

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Abstract

Background

An increasing rate of encephalopathy associated with coronavirus disease 2019 (COVID-19) has been observed among children. However, the literature on neuroimaging data in children with COVID-19 is limited.

Objective

To analyze brain magnetic resonance imaging (MRI) of pediatric COVID-19 patients with neurological complications.

Materials and methods

This multicenter retrospective observational study analyzed clinical (n=102, 100%) and neuroimaging (n=93, 91.2%) data of 102 children with COVID-19 infections and comorbid acute neurological symptoms. These children were hospitalized at five pediatric intensive care units (PICUs) in China between December 1, 2022, and January 31, 2023.

Results

All patients were positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as detected via reverse transcriptase polymerase chain reaction. About 75.7% of the children were infected with the Omicron variant BF.7 strain. Brain MRI was performed 1–12 days following the onset of neurological symptoms, which revealed acute neuroimaging findings in 74.2% (69/93) of cases, including evidence of acute necrotizing encephalopathy (33/69, 47.8%), encephalitis (31/69, 44.9%), reversible splenial lesion syndrome (3/69, 4.3%), reversible posterior leukoencephalopathy (1/69, 1.4%), and hippocampal atrophy (1/69, 1.4%).

Conclusions

Overall, these data highlighted five neuroimaging patterns associated with the outbreak of the SARS-CoV-2 Omicron variant, with acute necrotizing encephalopathy being the most common of these neuroimaging findings. Rarely, the brain MRI of these pediatric COVID-19 patients also demonstrate hippocampal atrophy.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Pediatric Intensive Care Unit, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, People’s Republic of China

    Chun Zhao, Yujuan Wang & Youpeng Jin

  2. Department of Pediatrics, Zibo Maternal and Child Health Care Hospital, Zibo, Shandong Province, People’s Republic of China

    Jian Hou

  3. Department of Pediatrics, Affiliated Hospital of Jining Medical University, Jining, Shandong Province, People’s Republic of China

    Meiyun Xin

  4. Department of Pediatric Intensive Care Unit, Qilu Children’s Hospital of Shangdong University, Jinan, Shandong Province, People’s Republic of China

    Qin Jiang

  5. Department of Pediatrics, Linyi People’s Hospital, Linyi, Shandong Province, People’s Republic of China

    Mingying Han

  6. Department of Pediatric Intensive Care Unit, Binzhou Medical University Hospital, Binzhou, Shandong Province, People’s Republic of China

    Xiaomei Li

  7. Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, People’s Republic of China

    Yelong Shen & Ximing Wang

  8. Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, People’s Republic of China

    Mo Wang

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  1. Chun Zhao
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  11. Youpeng Jin
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Contributions

All authors contributed to the study conception and design. J.Y.P and W.M conceived, supervised, and supported the study. Material preparation, data collection, and analysis were performed by W.Y.J., H.J., X.M.Y., J.Q., H.M.Y., and L.X.M. S.Y.L. and W.X.M. interpreted the images. The first draft of the manuscript was written by Z.C. and W.Y.J. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Youpeng Jin.

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Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Research Ethics Board (No. 2023-059).

Informed consent

Written informed consent was waived by the institutional review board.

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None

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Chun Zhao and Yujuan Wang both contributed equally to this work and share the first authorship.

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Zhao, C., Wang, Y., Hou, J. et al. Brain magnetic resonance imaging findings in children with neurological complications of coronavirus disease 2019 (Omicron variant): a multicenter retrospective observational study. Pediatr Radiol (2024). https://doi.org/10.1007/s00247-024-05908-6

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  • DOI: https://doi.org/10.1007/s00247-024-05908-6

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