Unraveling the link: SARS‑CoV‑2 infections and seizures in pediatric patients (Review)

Coronavirus disease 2019 (COVID‑19) caused by the highly infectious severe acute respiratory syndrome coronavirus‑2 (SARS‑CoV‑2) is a relatively recent emerging public welfare issue due to the rapid pandemic diffusion of the infection and to the new data acquisitions on the acute and chronic consequences related to the disorder. The first clinical manifestations identified were the involvement of the respiratory tract, with mild fever, rhinorrhea, cough and shortness of breath; these are the most frequently reported symptoms. Adults who are older, of the male sex, have cardiovascular issues, are obese, and have high blood pressure or diabetes are more likely to have a poor outcome following infection. This is true for both healthy children and adults who are otherwise healthy. In individuals with COVID‑19, neurological involvement varies, presenting with mild, or severe clinical complications; seizures are known to be the most common neurological manifestation. Neurological manifestations in childhood are less common and usually less severe than those observed in adults and may present with variable features involving the central, as well as the peripheral nervous system. The present literature review discusses the link between COVID‑19 infection and infection‑related seizures in children, as well as the effects of COVID‑19 infection in children affected by epilepsy. Seizures in COVID‑19 may raise from direct infectious, inflammatory or vascular causal effects on central nervous system structures. Indirect effects due to previous systemic disruptions or complications provoked by COVID‑19 infection are other suggestive causes. The effects of COVID‑19 infection on children affected by epilepsy and COVID‑19 as possible causal ground for subsequent epilepsy are also discussed herein. The vaccination, early diagnosis and the correct treatment of children affected by COVID‑19 are relevant factors for preventing the more aggressive course of the disorder and for preventing cerebral involvement, which may be the cause of subsequent severe clinical complications.