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June 2022; 12 (3) Clinical/Scientific Note

Cerebral White Matter Injury in a Newborn Infant With COVID-19

A Case Report

Lucas Alves, Thaís Alcântara, Adriano Hazin, Leandro Lucato, Jurandy Júnior Ferraz de Magalhães, Joao Alves, Jucille Meneses
First published April 21, 2022, DOI: https://doi.org/10.1212/CPJ.0000000000001173
Lucas Alves
Department of Neuropediatric (LA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Neonatology (TA, JM), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (AH), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (LL), Hospital das Clínicas da Universidade de São Paulo; Department of Virology (JJFM), Pernambuco State Central Laboratory (LACEN/PE); and Department of Pediatrics (JA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil.
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Thaís Alcântara
Department of Neuropediatric (LA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Neonatology (TA, JM), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (AH), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (LL), Hospital das Clínicas da Universidade de São Paulo; Department of Virology (JJFM), Pernambuco State Central Laboratory (LACEN/PE); and Department of Pediatrics (JA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil.
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  • For correspondence: ttalcantara@gmail.com
Adriano Hazin
Department of Neuropediatric (LA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Neonatology (TA, JM), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (AH), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (LL), Hospital das Clínicas da Universidade de São Paulo; Department of Virology (JJFM), Pernambuco State Central Laboratory (LACEN/PE); and Department of Pediatrics (JA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil.
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  • For correspondence: adrianohazin@hotmail.com
Leandro Lucato
Department of Neuropediatric (LA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Neonatology (TA, JM), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (AH), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (LL), Hospital das Clínicas da Universidade de São Paulo; Department of Virology (JJFM), Pernambuco State Central Laboratory (LACEN/PE); and Department of Pediatrics (JA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil.
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  • For correspondence: leandro.lucato@hc.fm.usp.br
Jurandy Júnior Ferraz de Magalhães
Department of Neuropediatric (LA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Neonatology (TA, JM), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (AH), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (LL), Hospital das Clínicas da Universidade de São Paulo; Department of Virology (JJFM), Pernambuco State Central Laboratory (LACEN/PE); and Department of Pediatrics (JA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil.
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  • For correspondence: jurandy.magalhaes@upe.br
Joao Alves
Department of Neuropediatric (LA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Neonatology (TA, JM), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (AH), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (LL), Hospital das Clínicas da Universidade de São Paulo; Department of Virology (JJFM), Pernambuco State Central Laboratory (LACEN/PE); and Department of Pediatrics (JA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil.
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  • For correspondence: joaoguilherme@imip.org.br
Jucille Meneses
Department of Neuropediatric (LA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Neonatology (TA, JM), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (AH), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP); Department of Radiology (LL), Hospital das Clínicas da Universidade de São Paulo; Department of Virology (JJFM), Pernambuco State Central Laboratory (LACEN/PE); and Department of Pediatrics (JA), Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil.
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  • For correspondence: jucille.meneses@gmail.com
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Citation
Cerebral White Matter Injury in a Newborn Infant With COVID-19
A Case Report
Lucas Alves, Thaís Alcântara, Adriano Hazin, Leandro Lucato, Jurandy Júnior Ferraz de Magalhães, Joao Alves, Jucille Meneses
Neurol Clin Pract Jun 2022, 12 (3) e22-e24; DOI: 10.1212/CPJ.0000000000001173

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Abstract

Because the COVID-19 pandemic evolves, reports of neurologic manifestations and neuroimaging associated with SARS-CoV-2 have been reported in children and in neonates, although very few when compared with adults.

Objectives To describe a 3-day-old neonate presenting afebrile seizures with a persistent positive nasopharyngeal swab for SARS-CoV-2 and neuroimaging demonstrating extensive cerebral white matter injury.

Methods Consent was obtained to report this case. SARS-CoV-2 was tested using real-time reverse transcriptase-polymerase chain reaction amplification of virus acid from a nasopharyngeal swab. MRI of the brain was performed using axial T1, T2, fluid-attenuated inversion recovery, diffusion-weighted imaging, and T1 postcontrast sequences.

Results Brain MRI showed restricted diffusion in the periventricular white matter, subcortical white matter, and splenium of the corpus callosum.

Discussion Neurologic presentation of SARS-CoV-2 in newborns seems to be rare and is not fully known. SARS-CoV-2 infection should be considered in newborns with seizures and white matter abnormalities.

Footnotes

  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • Submitted and externally peer reviewed. The handling editor was Luca Bartolini, MD.

  • NPub.org/COVID19

  • Received August 20, 2021.
  • Accepted January 12, 2022.
  • © 2022 American Academy of Neurology
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