COVID-19 in an adolescent with cerebral palsy: A case report

Authors

DOI:

https://doi.org/10.33448/rsd-v10i9.17822

Keywords:

Cerebral palsy; Epilepsy; Cytokines; Continuous Positive Airway Pressure; Covid-19; Case reports.

Abstract

Background: Children have been impacted by COVID-19 pandemics and biological mechanisms of host response are under active investigation worldwide to develop better treatment plans. Children with cerebral palsy (CP) diagnosis are less studied, although they present increased risk for COVID-19 disease (COVID-CP). Here, we aim to report the diagnosis and treatment plan to further improve clinical protocols for COVID-CP patients. Case Presentation: This case report describes a 12-year-old male diagnosed with neuropsychomotor developmental delay, chronic non-progressive encephalopathy, spastic tetraparesis, epilepsy and recently COVID-19 disease.  SARS-CoV-2 viral detection was assayed by RT-PCR swab (nasopharynx and oropharynx) concomitantly with family members. Subject presented symptoms after 3 days of confirmed diagnostics and presented positive viral even after 2 weeks of testing, suggesting long exposure to the virus. The unique signs and symptoms led the treatment plan to focus on maintaining oxygen levels, management of severe lung phenotype, and control of increased seizures. In addition, levels of inflammatory cytokines were monitored to predict risk of cytokine storm, risk for multisystemic inflammatory syndrome (MISC), and need for continuous hospitalization. A pharmacological treatment protocol for asthma was implemented in association to vigorous monitoring by caregivers and family members. The course of the viral phase, from its onset to negativity, was longer than the average time of 14 days. Conclusion: Clinical manifestations, complementary exams and treatment are discussed to better improve protocols of COVID-CP patients.

Author Biographies

Ângela Toshie Araki Yamamoto, Cruzeiro do Sul University

Associate Professor, Endodontics, Postgraduate Program in Dentistry, Cruzeiro do Sul University

Ana Cristina Fernandes Maria Ferreira, Cruzeiro do Sul University

Ph.D student, Postgraduate Program in Dentistry, Cruzeiro do Sul University

André Hayato Saguchi, Cruzeiro do Sul University

Ph.D student, Postgraduate Program in Dentistry, Cruzeiro do Sul University

Marcelo Freire, J. Craig Venter Institute, San Diego, Califórnia

Associate Professor, J. Craig Venter Institute, San Diego, Califórnia, United States.

Maria Teresa Botti Rodrigues Santos, Cruzeiro do Sul University

Associate Professor, Individuals with Special Needs, Postgraduate Program in  Dentistry, Cruzeiro do Sul University

References

CDC. (2019a). COVID-19 Pandemic Planning Scenarios. Centers for Disease Control and Prevention (CDC) website. https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html#table-2.

CDC. (2019b). Health care facilieites. Centers for Disease Control and Prevention (CDC) website. https://www.cdc.gov/coronavirus/2019-ncov/hcp/us-healthcare-facilities.html.

CDC. (2020). Daily-life-coping/ children/mis-c. Centers for Disease Control and Prevention (CDC) website. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/children/mis-c.html.

Chen, Z. M., Fu, J. F., Shu, Q., Chen, Y. H., Hua, C. Z., Li, F. B., . . . Zhang, Y. Y. (2020). Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr, 16(3), 240-246. doi:10.1007/s12519-020-00345-5

Dove, M. L., Jaggi, P., Kelleman, M., Abuali, M., Ang, J. Y., Ballan, W., . . . Oster, M. E. (2021). Multisystem Inflammatory Syndrome in Children: Survey of Protocols for Early Hospital Evaluation and Management. J Pediatr, 229, 33-40. doi:10.1016/j.jpeds.2020.10.026

Esposito, S., & Principi, N. (2020). To mask or not to mask children to overcome COVID-19. Eur J Pediatr, 179(8), 1267-1270. doi:10.1007/s00431-020-03674-9

Fantozzi, P. J., Pampena, E., Di Vanna, D., Pellegrino, E., Corbi, D., Mammucari, S., . . . Villa, A. (2020). Xerostomia, gustatory and olfactory dysfunctions in patients with COVID-19. Am J Otolaryngol, 41(6), 102721. doi:10.1016/j.amjoto.2020.102721

Fisher, K. A., Barile, J. P., Guerin, R. J., Vanden Esschert, K. L., Jeffers, A., Tian, L. H., . . . Prue, C. E. (2020). Factors Associated with Cloth Face Covering Use Among Adults During the COVID-19 Pandemic - United States, April and May 2020. MMWR Morb Mortal Wkly Rep, 69(28), 933-937. doi:10.15585/mmwr.mm6928e3

Guan, W. J., Ni, Z. Y., Hu, Y., Liang, W. H., Ou, C. Q., He, J. X., . . . China Medical Treatment Expert Group for, C. (2020). Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med, 382(18), 1708-1720. doi:10.1056/NEJMoa2002032

Heald-Sargent, T., Muller, W. J., Zheng, X., Rippe, J., Patel, A. B., & Kociolek, L. K. (2020). Age-Related Differences in Nasopharyngeal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Levels in Patients With Mild to Moderate Coronavirus Disease 2019 (COVID-19). JAMA Pediatr, 174(9), 902-903. doi:10.1001/jamapediatrics.2020.3651

Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., . . . Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 395(10223), 497-506. doi:10.1016/S0140-6736(20)30183-5

Jiehao, C., Jin, X., Daojiong, L., Zhi, Y., Lei, X., Zhenghai, Q., . . . Mei, Z. (2020). A Case Series of Children With 2019 Novel Coronavirus Infection: Clinical and Epidemiological Features. Clin Infect Dis, 71(6), 1547-1551. doi:10.1093/cid/ciaa198

Kabeerdoss, J., Pilania, R. K., Karkhele, R., Kumar, T. S., Danda, D., & Singh, S. (2021). Severe COVID-19, multisystem inflammatory syndrome in children, and Kawasaki disease: immunological mechanisms, clinical manifestations and management. Rheumatol Int, 41(1), 19-32. doi:10.1007/s00296-020-04749-4

Mustafa, N. M., & L, A. S. (2020). Characterisation of COVID-19 Pandemic in Paediatric Age Group: A Systematic Review and Meta-Analysis. J Clin Virol, 128, 104395. doi:10.1016/j.jcv.2020.104395

Needleman, J. S., & Hanson, A. E. (2020). COVID-19-associated apnea and circumoral cyanosis in a 3-week-old. BMC Pediatr, 20(1), 382. doi:10.1186/s12887-020-02282-8

Qiu, C., Cui, C., Hautefort, C., Haehner, A., Zhao, J., Yao, Q., . . . Lu, H. (2020). Olfactory and Gustatory Dysfunction as An Early Identifier of COVID-19 in Adults and Children: An International Multicenter Study. medRxiv. doi:10.1101/2020.05.13.20100198

Rogatsky, I., & Ivashkiv, L. B. (2006). Glucocorticoid modulation of cytokine signaling. Tissue Antigens, 68(1), 1-12. doi:10.1111/j.1399-0039.2006.00599.x

Shen, K. L., Yang, Y. H., Jiang, R. M., Wang, T. Y., Zhao, D. C., Jiang, Y., . . . Global Pediatric Pulmonology, A. (2020). Updated diagnosis, treatment and prevention of COVID-19 in children: experts' consensus statement (condensed version of the second edition). World J Pediatr, 16(3), 232-239. doi:10.1007/s12519-020-00362-4

Szablewski, C. M., Chang, K. T., Brown, M. M., Chu, V. T., Yousaf, A. R., Anyalechi, N., . . . Stewart, R. J. (2020). SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp - Georgia, June 2020. MMWR Morb Mortal Wkly Rep, 69(31), 1023-1025. doi:10.15585/mmwr.mm6931e1

Wu, Z., & McGoogan, J. M. (2020). Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA, 323(13), 1239-1242. doi:10.1001/jama.2020.2648

Published

21/07/2021

How to Cite

YAMAMOTO, Ângela T. A.; FERREIRA, A. C. F. M. .; SAGUCHI, A. H.; FREIRE, M.; SANTOS, M. T. B. R. . COVID-19 in an adolescent with cerebral palsy: A case report. Research, Society and Development, [S. l.], v. 10, n. 9, p. e7710917822, 2021. DOI: 10.33448/rsd-v10i9.17822. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/17822. Acesso em: 20 sep. 2021.

Issue

Section

Health Sciences