Neurological and Neuroimaging Implications of COVID-19 in the Pediatric Population

While COVID-19 is no longer the “hot-topic” it was 2 years ago, its prevalence and impact are still significant. In 2022, the CDC estimated that over 90% of children from 6 months to 17 years old have had COVID-19 infection. While most children have limited and mild symptoms, a substantial subset experiences significant neurological manifestations and/or complications which may lead to long-lasting morbidity or even mortality. Such neurological manifestations of SARS-CoV-2 include acute encephalitis, seizures, central demyelinating disease, cerebrovascular events, peripheral neurological disorders, and chronic symptoms in the setting of long COVID, which may affect up to 25% of infected children and adolescents. Given the high prevalence of COVID-19 in the general and pediatric population, it is essential for clinicians to understand the full breadth of its potential effects. In this article, we review common neurological manifestations and sequelae of SARS-CoV-2 in the pediatric population and describe their prevalence, timing, and associated neuroimaging findings.