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

Detalhes bibliográficos
Autor(a) principal: Yamamoto, Ângela Toshie Araki
Data de Publicação: 2021
Outros Autores: Ferreira, Ana Cristina Fernandes Maria, Saguchi, André Hayato, Freire, Marcelo, Santos, Maria Teresa Botti Rodrigues
Tipo de documento: Artigo
Idioma: por
Título da fonte: Research, Society and Development
Texto Completo: https://rsdjournal.org/index.php/rsd/article/view/17822
Resumo: 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.
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spelling COVID-19 in an adolescent with cerebral palsy: A case reportCOVID-19 en un adolescente con parálisis cerebral: Informe de un casoCOVID-19 em um adolescente com paralisia cerebral: Um relato de casoCerebral palsyEpilepsyCytokinesContinuous Positive Airway PressureCovid-19Case reports.Paralisia cerebralEpilepsiaCitocinasPressão positiva nas vias aéreasCovid-19Relatos de casos.Parálisis cerebralEpilepsiaCitocinasPresión de las Vías Aéreas Positiva ContínuaCovid-19Informes de casos.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.Introducción: los niños son afectados por la pandemia de COVID-19 y los mecanismos biológicos de la respuesta inmunológica son investigados en todo el mundo. Los niños con parálisis cerebral (PC) son menos estudiados, aunque presentan un mayor riesgo de enfermedad COVID-19 (COVID-PC). El objetivo de estudio es informar el diagnóstico y tratamiento para mejorar los protocolos clínicos de estos pacientes. Presentación del caso: Este informe de caso describe un niño de 12 años diagnosticado con retraso del desarrollo neuropsicomotor, encefalopatía crónica no progresiva, tetraparesia espástica, epilepsia y COVID-19. La detección del SARS-CoV-2 se analizó mediante un hisopo RT-PCR (nasofaringe y orofaringe) concomitantemente con parientes. Él presentó síntomas después de 3 días de diagnóstico confirmado y virus positivo después de 2 semanas de prueba, sugiriendo una exposición prolongada al virus. Los signos y síntomas únicos llevaron a centrarse en mantener los niveles de oxígeno, el manejo del fenotipo pulmonar severo y el control del aumento de las convulsiones. Además, se controlaron los niveles de citocinas inflamatorias para reducir el riesgo de tormenta de citocinas, síndrome inflamatorio multisistémico (MISC) y la necesidad de hospitalización. Se implementó un protocolo de tratamiento farmacológico para el asma en asociación con un seguimiento riguroso por parte de los cuidadores y familiares. El curso de la fase viral, desde su inicio hasta la negatividad, fue más largo que el tiempo promedio de 14 días. Conclusión: Se discuten las manifestaciones clínicas, los exámenes complementarios y el tratamiento para mejorar los protocolos de los pacientes con COVID-PC.Introdução: Crianças são afetadas por pandemias de COVID-19 e os mecanismos biológicos de resposta do hospedeiro estão sob investigação em todo o mundo. Crianças com diagnóstico de paralisia cerebral (PC) são menos estudadas, embora apresentem risco aumentado para doença COVID-19 (COVID-PC). O objetivo é relatar o diagnóstico e plano de tratamento para melhorar ainda mais os protocolos clínicos para pacientes com COVID-PC. Apresentação do caso: Descreve-se um relato de caso de um adolescente de 12 anos com diagnóstico de atraso no desenvolvimento neuropsicomotor, encefalopatia crônica não progressiva, tetraparesia espástica, epilepsia e COVID-19. A detecção do vírus SARS-CoV-2 foi avaliada por swab de RT-PCR (nasofaringe e orofaringe) concomitantemente com membros da família. Ele apresentou sintomas após 3 dias do diagnóstico e apresentou vírus positivo após 2 semanas de teste, sugerindo longa exposição ao vírus. Os sinais e sintomas únicos levaram a se concentrarem na manutenção dos níveis de oxigênio, no manejo do fenótipo pulmonar grave e no controle do aumento das convulsões. Além disso, os níveis de citocinas inflamatórias foram monitorados para prever o risco de tempestade de citocinas, risco de síndrome inflamatória multissistêmica (MISC) e necessidade de hospitalização contínua. Um protocolo de tratamento farmacológico para asma foi implementado em associação ao monitoramento vigoroso por cuidadores e familiares. O curso da fase viral, do início à negatividade, foi mais longo do que o tempo médio de 14 dias. Conclusão: As manifestações clínicas, exames complementares e tratamento são discutidos para melhor aprimorar os protocolos dos pacientes com COVID-PC.Research, Society and Development2021-07-21info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://rsdjournal.org/index.php/rsd/article/view/1782210.33448/rsd-v10i9.17822Research, Society and Development; Vol. 10 No. 9; e7710917822Research, Society and Development; Vol. 10 Núm. 9; e7710917822Research, Society and Development; v. 10 n. 9; e77109178222525-3409reponame:Research, Society and Developmentinstname:Universidade Federal de Itajubá (UNIFEI)instacron:UNIFEIporhttps://rsdjournal.org/index.php/rsd/article/view/17822/15913Copyright (c) 2021 Ângela Toshie Araki Yamamoto; Ana Cristina Fernandes Maria Ferreira; André Hayato Saguchi; Marcelo Freire; Maria Teresa Botti Rodrigues Santoshttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessYamamoto, Ângela Toshie ArakiFerreira, Ana Cristina Fernandes Maria Saguchi, André HayatoFreire, MarceloSantos, Maria Teresa Botti Rodrigues 2021-09-12T14:28:06Zoai:ojs.pkp.sfu.ca:article/17822Revistahttps://rsdjournal.org/index.php/rsd/indexPUBhttps://rsdjournal.org/index.php/rsd/oairsd.articles@gmail.com2525-34092525-3409opendoar:2024-01-17T09:38:05.676268Research, Society and Development - Universidade Federal de Itajubá (UNIFEI)false
dc.title.none.fl_str_mv COVID-19 in an adolescent with cerebral palsy: A case report
COVID-19 en un adolescente con parálisis cerebral: Informe de un caso
COVID-19 em um adolescente com paralisia cerebral: Um relato de caso
title COVID-19 in an adolescent with cerebral palsy: A case report
spellingShingle COVID-19 in an adolescent with cerebral palsy: A case report
Yamamoto, Ângela Toshie Araki
Cerebral palsy
Epilepsy
Cytokines
Continuous Positive Airway Pressure
Covid-19
Case reports.
Paralisia cerebral
Epilepsia
Citocinas
Pressão positiva nas vias aéreas
Covid-19
Relatos de casos.
Parálisis cerebral
Epilepsia
Citocinas
Presión de las Vías Aéreas Positiva Contínua
Covid-19
Informes de casos.
title_short COVID-19 in an adolescent with cerebral palsy: A case report
title_full COVID-19 in an adolescent with cerebral palsy: A case report
title_fullStr COVID-19 in an adolescent with cerebral palsy: A case report
title_full_unstemmed COVID-19 in an adolescent with cerebral palsy: A case report
title_sort COVID-19 in an adolescent with cerebral palsy: A case report
author Yamamoto, Ângela Toshie Araki
author_facet Yamamoto, Ângela Toshie Araki
Ferreira, Ana Cristina Fernandes Maria
Saguchi, André Hayato
Freire, Marcelo
Santos, Maria Teresa Botti Rodrigues
author_role author
author2 Ferreira, Ana Cristina Fernandes Maria
Saguchi, André Hayato
Freire, Marcelo
Santos, Maria Teresa Botti Rodrigues
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Yamamoto, Ângela Toshie Araki
Ferreira, Ana Cristina Fernandes Maria
Saguchi, André Hayato
Freire, Marcelo
Santos, Maria Teresa Botti Rodrigues
dc.subject.por.fl_str_mv Cerebral palsy
Epilepsy
Cytokines
Continuous Positive Airway Pressure
Covid-19
Case reports.
Paralisia cerebral
Epilepsia
Citocinas
Pressão positiva nas vias aéreas
Covid-19
Relatos de casos.
Parálisis cerebral
Epilepsia
Citocinas
Presión de las Vías Aéreas Positiva Contínua
Covid-19
Informes de casos.
topic Cerebral palsy
Epilepsy
Cytokines
Continuous Positive Airway Pressure
Covid-19
Case reports.
Paralisia cerebral
Epilepsia
Citocinas
Pressão positiva nas vias aéreas
Covid-19
Relatos de casos.
Parálisis cerebral
Epilepsia
Citocinas
Presión de las Vías Aéreas Positiva Contínua
Covid-19
Informes de casos.
description 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.
publishDate 2021
dc.date.none.fl_str_mv 2021-07-21
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://rsdjournal.org/index.php/rsd/article/view/17822
10.33448/rsd-v10i9.17822
url https://rsdjournal.org/index.php/rsd/article/view/17822
identifier_str_mv 10.33448/rsd-v10i9.17822
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://rsdjournal.org/index.php/rsd/article/view/17822/15913
dc.rights.driver.fl_str_mv https://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Research, Society and Development
publisher.none.fl_str_mv Research, Society and Development
dc.source.none.fl_str_mv Research, Society and Development; Vol. 10 No. 9; e7710917822
Research, Society and Development; Vol. 10 Núm. 9; e7710917822
Research, Society and Development; v. 10 n. 9; e7710917822
2525-3409
reponame:Research, Society and Development
instname:Universidade Federal de Itajubá (UNIFEI)
instacron:UNIFEI
instname_str Universidade Federal de Itajubá (UNIFEI)
instacron_str UNIFEI
institution UNIFEI
reponame_str Research, Society and Development
collection Research, Society and Development
repository.name.fl_str_mv Research, Society and Development - Universidade Federal de Itajubá (UNIFEI)
repository.mail.fl_str_mv rsd.articles@gmail.com
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