국내 소아에서 심한 COVID-19 뇌염에서 성공적으로 회복된 1례
The Case of Successful Recovery From Severe Encephalitis in a COVID-19 Pediatric Patient in Korea
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2023년 9월까지 19세이하소아청소년인구의 90% 이상에서코로나바이러스감염증-19 (coronavirus disease 2019, COVID-19) 감염력이 있으며, 그중 40–60%에서 두통, 경련발작, 뇌염 등의 신경학적 증상이 보고되고 있다. 본 증례에서 저자들은severe acute respiratory syndrome coronavirus 2 감염 후 경련과 의식 변화로 내원, COVID-19 뇌염으로 진단하여 정맥내면역글로불린, 고용량 스테로이드, 항바이러스제, 항경련제 투여 등의 적극적인 치료로 회복된 3세 여자 환자를 보고하고자한다. 환자는 입원 39일차 말하기와 혼자 걷기가 가능한 상태로 퇴원하였고 발병 1년이 지난 시점, 경한 언어 지연을 보이나전반적으로 좋은 예후를 보이고 있다. COVID-19 뇌염 환자에서 조기 발견과 적극적인 치료가 긍정적인 예후와 연관됨을 본증례를 통하여 보고하는 바이다.
Abstract
In Korea, >90% of children and adolescents aged <19 years have been infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since 2020. Among confirmed cases of pediatric coronavirus disease 2019 (COVID-19), 40–60% of patients developed neurologic symptoms such as seizures, headache, and encephalitis. Herein, we report the case of a 3-year-old female patient with SARS-CoV-2 infection who presented with seizures and altered consciousness and was diagnosed with COVID-19 encephalitis. The patient recovered after treatment with intravenous immunoglobulin, high-dose steroids, anti-seizure drugs, and an anti-viral agent. She was discharged after regaining the ability to speak words and walk alone on hospital day 39. Complete recovery was observed at the 1-year follow-up. The findings in this case suggest that early detection and active intervention is associated with better outcomes in patients with COVID-19 encephalitis.
참고문헌 (20)
- "Cases in Korea" (2023)[URL]
- Mao L, "Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China", JAMA Neurol, 77, pp.683~690 (2020)
- 김현경, "Neurological Manifestations in Patients with COVID-19: Experiences from the Central Infectious Diseases Hospital in South Korea", Journal of Clinical Neurology, 17(3), pp.435~442 (2021), 대한신경과학회[DOI]
- Hyunju Lee, "Analysis of Critical COVID-19 Cases Among Children in Korea", Journal of Korean Medical Science, 37(1), pp.1~10 (2022), 대한의학회[DOI]
- Valderas C, "COVID-19 and neurologic manifestations : a synthesis from the child neurologist’s corner", World J Pediatr, 18, pp.373~382 (2022)
- Kumar R, "Understanding and managing acute encephalitis", F1000 Res, 9, pp.F1000 Faculty Rev-60~ (2020)[DOI]
- Urso L, "The case of encephalitis in a COVID-19 pediatric patient", Neurol Sci, 43, pp.105~112 (2022)
- Yusak Mangara Tua Siahaan, "COVID-19-Associated Encephalopathy: Systematic Review of Case Reports", Journal of Clinical Neurology, 18(2), pp.194~206 (2022), 대한신경과학회
- Burr T, "N-methyl-d-aspartate receptor encephalitis associated with COVID-19 infection in a toddler", Pediatr Neurol, 114, pp.75~76 (2021)
- Pilotto A, "Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)encephalitis is a cytokine release syndrome : evidences from cerebrospinal fluid analyses", Clin Infect Dis, 73, pp.e3019~e3026 (2021)
- Lindan CE, "Neuroimaging manifestations in children with SARS-CoV-2 infection : a multinational, multicentre collaborative study", Lancet Child Adolesc Health, 5, pp.167~177 (2021)
- Graham EL, "Therapeutic approaches to the neurologic manifestations of COVID-19", Neurotherapeutics, 19, pp.1435~1466 (2022)
- Grundmann A, "Fewer COVID-19 neurological complications with dexamethasone and remdesivir", Ann Neurol, 93, pp.88~102 (2023)
- Pöyhönen H, "Neurological and cognitive performance after childhood encephalitis", Front Pediatr, 9, pp.646684~ (2021)
- Brisca G, "Acute pediatric encephalitis : etiology, course, and outcome of a 12-year single-center immunocompetent cohort", J Neurol, 270, pp.5034~5047 (2023)
- Chang YM, "Case report : Distinct neurologic manifestation and cytokine profile of a child with COVID-19-associated acute fulminant encephalitis", Front Med(Lausanne), 10, pp.1209656~ (2023)
- Da Som Park, "Acute Necrotizing Encephalopathy in Children with COVID-19 Accompanied by Multisystem Inflammatory Syndrome", Annals of Child Neurology, 32(1), pp.49~52 (2024), 대한소아신경학회[DOI]
- Abdelhady M, "Encephalitis following COVID-19 vaccination : a systematic review", Vaccines(Basel), 11, pp.576~ (2023)
- Kim Kyung Min, "Rapid Progression to Brainstem Encephalitis Caused by Enterovirus 71 Without Throat and Skin Lesions After a One-Day Fever", Pediatric Infection and Vaccine, 30(2), pp.91~96 (2023), 대한소아감염학회[DOI]
- Islam MA, "Encephalitis in patients with COVID-19 : a systematic evidence-based analysis", Cells, 11, pp.2575~ (2022)