Objectives: Since April 2022, another wave of the Omicron epidemic stroke Taiwan society, and children with severe neurological complications have been reported frequently. A few cases even developed acute fulminant encephalitis. To investigate the possible causes of the increased incidence of such complications here in Taiwan, we reviewed several cases of pediatric patients with severe neurological symptoms. Materials and Methods: We collected the medical records of pediatric patients with COVID-19 infection who presented with severe neurological symptoms. The COVID-19 infection was diagnosed by nasal swab RT-PCR. The remained samples were sent for whole-genome sequencing and S protein amino acid variation mapping. Results: The increased of several inflammatory markers was observed in all patients included in this article displayed. However, none of the cerebrospinal fluid (CSF) samples tested positive for SARS-CoV-2. The result of WGS showed that all the sequences belonged to the lineage BA.2.3.7. However, the sequences had a K97E mutation in the S protein that differed from other BA.2.3.7 lineage strains which was located at the spike protein N-terminal domain. Conclusions: The new mutation in the S protein, which had not previously been observed but was discovered in this study, potentially explains the sudden increase in incidence of extremely adverse neurological symptoms in pediatric patients.
Fuente: International Journal of Infectious Diseases
Available online 8 September 2022
In Press, Journal Pre-proof