Evidence map›Paper›PMID 34929359›Full record

ArticleInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases2022

The case of fatal acute hemorrhagic necrotizing encephalitis in a two-month-old boy with Covid-19.

Magdalena Mierzewska-Schmidt, Artur Baranowski, Krystyna Szymanska, Michal Ciaston, Ernest Kuchar, Rafal Ploski, Joanna Kosinska, Izabela Pagowska-Klimek

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PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 4 pooled it
1.8field-weighted citation impact, top 12% of its field
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

21 citing papers in PubMed, 4 syntheses or guidelines pooled it, 29 citations in OpenAlex.

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  20. Exclude differentials before diagnosing SARS-CoV-2-associated acute haemorrhagic necrotising encephalitis.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Magdalena Mierzewska-SchmidtDepartment of Paediatric Anaesthesiology and Intensive Therapy, Medical University of Warsaw, Poland. 63a Zwirki i Wigury Str., 02-091. Electronic address: mcdosia@gmail.com.
Artur BaranowskiDepartment of Paediatric Anaesthesiology and Intensive Therapy, Medical University of Warsaw, Poland. 63a Zwirki i Wigury Str., 02-091. Electronic address: artur.baranowski@wum.edu.pl.
Krystyna SzymanskaDepartment of Experimental and Clinical Neuropathology, Mossakowski Medical Research Center, Polish Academy of Sciences, Warsaw, Poland. 5 Pawinskiego Str., 02-106 Warsaw. Electronic address: szymanska2@wp.pl.
Michal CiastonDepartment of Pediatric Radiology, Medical University of Warsaw, Poland. 63a Zwirki i Wigury Str., 02-091 Warsaw. Electronic address: inah3@interia.pl.
Ernest KucharDepartment of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Poland. 63a Zwirki i Wigury Str., 02-091 Warsaw. Electronic address: ernest.kuchar@gmail.com.
Rafal PloskiDepartment of Medical Genetics, Medical University of Warsaw, Poland. 3c Pawinskiego Str., 02-106 Warsaw. Electronic address: rploski@wp.pl.
Joanna KosinskaDepartment of Medical Genetics, Medical University of Warsaw, Poland. 3c Pawinskiego Str., 02-106 Warsaw. Electronic address: joanna.kosinska@wum.edu.pl.
Izabela Pagowska-KlimekDepartment of Paediatric Anaesthesiology and Intensive Therapy, Medical University of Warsaw, Poland. 63a Zwirki i Wigury Str., 02-091. Electronic address: izabela.pagowska-klimek@wum.edu.pl.
Medical University of Warsaw · PLMossakowski Medical Research Institute, Polish Academy of Sciences · PL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

SARS-CoV-2 infection in healthy children is usually benign. However, severe, life-threatening cases have previously been reported, notably in infants. We must be aware that data on the natural history of COVID-19 are still full of gaps, especially as far as the pediatric population is concerned. Therefore, it is important to describe rare manifestations of SARS-CoV-2 acute infection in children. Here we present the case of acute hemorrhagic necrotizing encephalitis (AHNE) in a previously healthy, 2-month-old male infant with SARS-CoV-2 infection. After 2 days of fever with signs of respiratory tract infection, neurological manifestations appeared: irritability, nystagmus, agitation then apathy. As a consequence of apnea, he required emergent intubation and was transferred to our PICU. Brain MRI revealed diffuse areas of oedema associated with numerous symmetrical changes with punctate hemorrhages in basal ganglia, thalami, brainstem, and cerebral gray matter. CSF was clear with pleocytosis 484 cells/µl, elevated lactic acid and protein. Despite broad microbiological testing, only SARS-CoV2 was detected in PCR nasal swab. Therefore, acute hemorrhagic necrotizing encephalitis (AHNE) as a result of COVID-19 was the most probable diagnosis. The outcome was unfavorable - brain death was confirmed, life support was withdrawn.

Indexed as

COVID-19Encephalitis, ViralChildHemorrhageHumansInfantMaleRNA, ViralSARS-CoV-2RNA, ViralchildCOVID-19encephalitisneurologicalSARS-CoV-2

Identifiers

PMID34929359
PMCPMC8683211
OpenAlexW4200072785

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.