Evidence map›Paper›PMID 33332607›Full record

ArticleAnnals of neurology2021

Pediatric Ischemic Stroke: An Infrequent Complication of SARS-CoV-2.

Lauren A Beslow, Alexandra B Linds, Christine K Fox, Manoëlle Kossorotoff, Yenny C Zuñiga Zambrano, Marta Hernández-Chávez, Sahar M A Hassanein, Susan Byrne, Ming Lim, Nkechi Maduaka and 9 more

Abstract read
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In one paragraph

Article in Annals of neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Observational
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Neurological complications caused by SARS-CoV-2.Clinical microbiology reviews · 2024
    Review
  11. Article
  12. Article
  13. Review
  14. Article
  15. Article
  16. Article
  17. Cerebrovascular Manifestations of SARS-CoV-2: A Comprehensive Review.Current treatment options in neurology · 2023
    Review
  18. Coronavirus Infection in Neonates: Neurodevelopmental Outcomes at 18 Months of Age.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2023
    Article
  19. Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Lauren A BeslowDivision of Neurology, Children's Hospital of Philadelphia, Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.ORCID 0000-0003-0571-980X
Alexandra B LindsDivision of Neurology, Department of Paediatrics, and Child Health Evaluative Sciences Program, The Hospital for Sick Children, Toronto, ON, Canada.
Christine K FoxDepartments of Neurology and Pediatrics, University of California San Francisco, San Francisco, CA.
Manoëlle KossorotoffFrench Center for Pediatric Stroke, Pediatric Neurology Department, APHP University Hospital Necker-Enfants Maladies, Paris, France.
Yenny C Zuñiga ZambranoUnit of Pediatric Neurology, Fundación, Hospital de la Misericordia, Bogotá, Colombia.
Marta Hernández-ChávezUnit of Neurology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Sahar M A HassaneinDepartment of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.ORCID 0000-0002-0191-8425
Susan ByrneEvelina London Children's Hospital, London, UK.
Ming LimEvelina London Children's Hospital, London, UK.
Nkechi MaduakaPaediatric Department, King's College Hospital, London, UK.
Dimitrios ZafeiriouDepartment of Pediatrics, Hippokratio General Hospital, Aristotle University, Thessaloniki, Greece.
Michael M DowlingDepartments of Pediatrics and Neurology, University of Texas Southwestern Medical Center, Dallas, TX.
Ryan J FellingDepartment of Neurology, Johns Hopkins School of Medicine, Baltimore, MD.ORCID 0000-0002-0845-9356
Mubeen F RafaySection of Neurology, Department of Pediatrics and Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada.
Laura L LehmanDepartment of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA.
Michael J NoetzelDepartments of Neurology and Pediatrics, Division of Pediatric and Developmental Neurology, Washington University School of Medicine, Neurorehabilitation Program, St. Louis Children's Hospital, St. Louis, MO.
Timothy J BernardSection of Child Neurology, Children's Hospital Colorado, Departments of Pediatrics and Neurology, Hemophilia and Thrombosis Center, University of Colorado School of Medicine, Aurora, CO.
Nomazulu DlaminiDivision of Neurology, Department of Paediatrics, and Child Health Evaluative Sciences Program, The Hospital for Sick Children, Toronto, ON, Canada.
International Pediatric Stroke Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSevere complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) include arterial ischemic stroke (AIS) in adults and multisystem inflammatory syndrome in children. Whether stroke is a frequent complication of pediatric SARS-CoV-2 is unknown. This study aimed to determine the proportion of pediatric SARS-CoV-2 cases with ischemic stroke and the proportion of incident pediatric strokes with SARS-CoV-2 in the first 3 months of the pandemic in an international cohort.

methodsWe surveyed 61 international sites with pediatric stroke expertise. Survey questions included: numbers of hospitalized pediatric (≤ 18 years) patients with SARS-CoV-2; numbers of incident neonatal and childhood ischemic strokes; frequency of SARS-CoV-2 testing for pediatric patients with stroke; and numbers of stroke cases positive for SARS-CoV-2 from March 1 to May 31, 2020.

resultsOf 42 centers with SARS-CoV-2 hospitalization numbers, 8 of 971 (0.82%) pediatric patients with SARS-CoV-2 had ischemic strokes. Proportions of stroke cases positive for SARS-CoV-2 from March to May 2020 were: 1 of 108 with neonatal AIS (0.9%), 0 of 33 with neonatal cerebral sinovenous thrombosis (CSVT; 0%), 6 of 166 with childhood AIS (3.6%), and 1 of 54 with childhood CSVT (1.9%). However, only 30.5% of neonates and 60% of children with strokes were tested for SARS-CoV-2. Therefore, these proportions represent 2.9, 0, 6.1, and 3.0% of stroke cases tested for SARS-CoV-2. Seven of 8 patients with SARS-CoV-2 had additional established stroke risk factors.

interpretationAs in adults, pediatric stroke is an infrequent complication of SARS-CoV-2, and SARS-CoV-2 was detected in only 4.6% of pediatric patients with ischemic stroke tested for the virus. However, < 50% of strokes were tested. To understand the role of SARS-CoV-2 in pediatric stroke better, SARS-CoV-2 testing should be considered in pediatric patients with stroke as the pandemic continues. ANN NEUROL 2021;89:657-665.

Indexed as

AdolescentChildChild, PreschoolCOVID-19FemaleHumansInfantInfant, NewbornIschemic StrokeMaleSARS-CoV-2Sinus Thrombosis, IntracranialSurveys and QuestionnairesSystemic Inflammatory Response Syndrome

Identifiers

PMID33332607

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.