perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2022-67-4-86-92perinatology-1679Research ArticleКЛИНИЧЕСКИЕ СЛУЧАИCLINICAL CASESНеврологические проявления COVID-19 у 5-летнего ребенкаNeurological manifestations of COVID-19 in a five-year-old childhttps://orcid.org/0000-0002-2290-0013БалыковаЛ. А.BalykovaL. A.

д.м.н., проф., член-корр. РАН, дир. медицинского института, 

430005 Саранск, ул. Большевистская, д. 68/1

Saransk

larisabalykova@yandex.ruhttps://orcid.org/0000-0003-0975-950XБойноваИ. В.BoynovaI. V.

д.м.н., проф. кафедры нервных болезней и психиатрии,

430005 Саранск, ул. Большевистская, д. 68/1

Saransk

https://orcid.org/0000-0001-5522-0359ИгнатьевВ. Н.IgnatyevV. N.

к.м.н., доц. кафедры инфекционных болезней с курсами эпидемиологии, фтизиатрии, кожных и венерических болезней, 

430005 Саранск, ул. Большевистская, д. 68/1

Saransk

https://orcid.org/0000-0002-4058-291XИгнатьеваО. И.IgnatievaO. I.

к.м.н., доц. кафедры нервных болезней и психиатрии,

430005 Саранск, ул. Большевистская, д. 68/1

Saransk

ФГБОУ ВО «Мордовский государственный университет им. Н.П. Огарева»РоссияOgarev National Research Mordovia State UniversityRussian Federation2022210920226748692Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20222022Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/1679

Новая коронавирусная инфекция (COVID-19; Corona Virus Disease 2019) — заболевание, вызываемое вирусом SARS-CoV-2, протекающее как в форме легкой острой респираторной вирусной инфекции, так и в тяжелой форме, с поражением различных органов и систем. У детей младше 16 лет, инфицированных SARS-CoV-2, в большинстве случаев заболевание протекает в легкой форме, без ярко выраженных неврологических проявлений.

В статье описан случай ассоциированного с SARS-CoV-2 острого диссеминированного энцефаломиелита у ребенка 5 лет, вызвавший сложности при дифференциальной диагностике с демиелинизирующими заболеваниями и наследственной патологией. Заболевание диагностировано в семье, где у обоих родителей диагноз COVID-19 был верифицирован методом полимеразной цепной реакции.

Поражение центральной нервной системы было представлено грубым центральным гемипарезом, вовлечением некоторых черепных нервов, с  нарушением функций тазовых органов. На фоне лечения отмечена положительная динамика в соматическом и неврологическом статусе. Пациент выписан на амбулаторное долечивание с удовлетворительным реабилитационным потенциалом. Поражение нервной системы SARS-COV-2 у  детей может приводить к  развитию фатальных состояний. Своевременная диагностика и комплексный подход к тактике ведения ребенка с энцефаломиелитом позволили избежать неблагоприятных последствий заболевания и улучшить реабилитационный прогноз. 

A new coronavirus infection (COVID-19, Corona Virus Disease 2019) is a disease caused by the SARS-CoV-2 virus, presenting as both a mild acute respiratory viral infection and a severe form, with damage to various organs and systems. In children under 16 years of age infected with SARS-CoV-2, the vast majority of cases were mild, without marked neurological manifestations.

This paper describes a case of acute disseminated encephalomyelitis in a five-year-old child associated with SARS-CoV-2, which caused difficulties in the differential diagnosis with demyelinating diseases and hereditary pathology. The disease was diagnosed in a family where both parentswere diagnosedwith COVID-19 by polymerase chain reaction (PCR).The CNSlesionwasrepresented by severe central hemiparesis, involvement of some cranial nerves, with impaired pelvic organ function. During the treatment there was a positive dynamicsin the somatic and neurologicalstatus. The patient was discharged for outpatient treatment with satisfactory rehabilitation potential.

SARS-CoV-2 lesions of the nervous system in children can lead to life-threatening and fatal conditions. Timely diagnosis and a comprehensive approach to the management of a child with encephalomyelitis made it possible to avoid adverse effects of the disease and improve the rehabilitation prognosis. 

детиSARS-CoV-2COVID-19пневмонияэнцефаломиелитнейровизуализацияchildrenSARS-CoV-2COVID-19pneumoniaencephalomyelitisneuroimagingReferencesCarod-Artal F.J. Neurological complications of coronavirus and COVID-19. Rev Neurol 2020; 70(9): 311-322. DOI: 10.33588/rn.7009.2020179Carod-Artal F.J. Neurological complications of coronavirus and COVID-19. Rev Neurol 2020; 70(9): 311-322. DOI: 10.33588/rn.7009.2020179Belopasov V.V., Yashu Y., Samoylova E.M., Baklaushev V.P. Nervous system damage in COVID-19. Clinical Practice 2020; 11(2): 60-80. DOI: 10.17816/clinpract34851Belopasov V.V., Yashu Y., Samoylova E.M., Baklaushev V.P. Nervous system damage in COVID-19. Clinical Practice 2020; 11(2): 60-80. DOI: 10.17816/clinpract34851Voytenkov V.B., Ekusheva E.V. To the question of neurotropicity and neuroinvasiveness of coronaviruses. Clinical Practice 2020; 11(2): 81-86. DOI: 10.17816/clinpract34890Voytenkov V.B., Ekusheva E.V. To the question of neurotropicity and neuroinvasiveness of coronaviruses. Clinical Practice 2020; 11(2): 81-86. DOI: 10.17816/clinpract34890Меркулов Ю.А., Коляк Е.В., Самохвалов Р.И., Меркулова Д.М., Костенко Е.В., Пятков А.А. и др. Нейроинвазивный потенциал SARS-CoV-2 и актуальные аспекты нейрореабилитации в условиях пандемии COVID-19. Аналитический обзор литературы. М., ГАУЗ МНПЦ МРВСМ ДЗМ, 2020; 53.Merkulov Yu.A., Kolyak E.V., Samokhvalov R.I., Merkulova D.M., Kostenko E.V., Piatkov A.A. et al. Neuroinvasive potential of SARS-CoV-2 and topical aspects of neurorehabilitation in COVID-19 pandemic conditions. Analytical literature review. M., GAUZ MNPC MRVSM DZM, 2020; 53 (in Russ.)Principi N., Esposito S. Are we sure that the neurological impact of COVID 19 in childhood has not been underestimated? Ital J Pediatr 2021; 47(1): 191. DOI: 10.1186/s13052-021-01144-yPrincipi N., Esposito S. Are we sure that the neurological impact of COVID 19 in childhood has not been underestimated? Ital J Pediatr 2021; 47(1): 191. DOI: 10.1186/s13052-021-01144-yLin J.E., Asfour A., Sewell T.B., Hooe B., Pryce P., Earley C. et al. Neurological issues in children with COVID-19. Neurosci Lett 2021; 743: 135567. DOI: 10.1016/j.neulet.2020.135567Lin J.E., Asfour A., Sewell T.B., Hooe B., Pryce P., Earley C. et al. Neurological issues in children with COVID-19. Neurosci Lett 2021; 743: 135567. DOI: 10.1016/j.neulet.2020.135567Alharbi M., Kazzaz Y.M., Hameed T., Alqanatish J., Alkhalaf H., Alsadoon А. et al. SARS-CoV-2 infection in children, clinical characteristics, diagnostic findings and therapeutic interventions at a tertiary care center in Riyadh, Saudi Arabia. J Infect Public Health 2021; 14(4): 446-453. DOI: 10.1016/j.jiph.2020.12.034Alharbi M., Kazzaz Y.M., Hameed T., Alqanatish J., Alkhalaf H., Alsadoon А. et al. SARS-CoV-2 infection in children, clinical characteristics, diagnostic findings and therapeutic interventions at a tertiary care center in Riyadh, Saudi Arabia. J Infect Public Health 2021; 14(4): 446-453. DOI: 10.1016/j.jiph.2020.12.034Временные методические рекомендации «Профилактика, диагностика и лечение возникающей коронавирусной инфекции (COVID-19). Версия 9» (Утв. Министерством здравоохранения Российской Федерации 26 октября 2020 г.). http://pervaya-pomoshh.net/versiya-9-metodicheskie-rekomendatsii-minzdrava-po-koronavirusu-ot-26-10-2020Provisional Methodological Recommendations «Prevention, diagnosis and treatment of emerging coronavirus infection (COVID-19). Version 9» (approved by the Ministry of Health of the Russian Federation on 26 October 2020 (in Russ) http://pervaya-pomoshh.net/versiya-9-metodicheskie-rekomendatsii-minzdrava-po-koronavirusu-ot-26-10-2020Needham E., Chou S., Coles A., Menon D. Neurological Implications of COVID-19 Infections. Neurocritical Care 2020; 32(3): 667-671. DOI: 10.1007/s12028-020-00978-4Needham E., Chou S., Coles A., Menon D. Neurological Implications of COVID-19 Infections. Neurocritical Care 2020; 32(3): 667-671. DOI: 10.1007/s12028-020-00978-4Guo Y., Cao Q., Hong Z., Tan Y., Chen S., Jin H. et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak — an update on the status. Mil Med Res 2020; 7: 11. DOI: 10.1186/s40779-020-00240-0Guo Y., Cao Q., Hong Z., Tan Y., Chen S., Jin H. et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak — an update on the status. Mil Med Res 2020; 7: 11. DOI: 10.1186/s40779-020-00240-0Maury A., Lyoubi A., Peiffer-Smadja N., Broucker T., Meppiel E. Neurological manifestations associated with SARSCoV-2 and other coronaviruses: A narrative review for clinicians. Rev Neurol (Paris) 2021; 177(1-2): 51-64. DOI: 10.1016/j.neurol.2020.10.001Maury A., Lyoubi A., Peiffer-Smadja N., Broucker T., Meppiel E. Neurological manifestations associated with SARSCoV-2 and other coronaviruses: A narrative review for clinicians. Rev Neurol (Paris) 2021; 177(1-2): 51-64. DOI: 10.1016/j.neurol.2020.10.001Veleri S. Neurotropism of SARS-CoV-2 and neurological diseases of the central nervous system in COVID-19 patients. Exp Brain Res 2022; 240(1): 9-25. DOI: 10.1007/s00221-021-06244-zVeleri S. Neurotropism of SARS-CoV-2 and neurological diseases of the central nervous system in COVID-19 patients. Exp Brain Res 2022; 240(1): 9-25. DOI: 10.1007/s00221-021-06244-zLechien J.R., Chiesa-Estomba C.M., De Siati D.R., Horoi M., Le Bon S., Rodriguezet А. et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol 2020; 277(8): 2251-2261. DOI: 10.1007/s00405-020-05965-1Lechien J.R., Chiesa-Estomba C.M., De Siati D.R., Horoi M., Le Bon S., Rodriguezet А. et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol 2020; 277(8): 2251-2261. DOI: 10.1007/s00405-020-05965-1Galougahi M., Ghorbani J., Bakhshayeshkaram M., Naeini A.S., Haseli S. Olfactory Bulb Magnetic Resonance Imaging in SARS-CoV-2-Induced Anosmia: The First Report. Acad Radiol 2020; 27(6): 892-893. DOI: 10.1016/j.acra.2020.04.002Galougahi M., Ghorbani J., Bakhshayeshkaram M., Naeini A.S., Haseli S. Olfactory Bulb Magnetic Resonance Imaging in SARS-CoV-2-Induced Anosmia: The First Report. Acad Radiol 2020; 27(6): 892-893. DOI: 10.1016/j.acra.2020.04.002Sharifian-Dorche M., Huot P., Osherov M., Wen D., Saveriano А., Giacomini P. Neurological complications of coronavirus infection; a comparative review and lessons learned during the COVID-19 pandemic. J Neurol Sci 2020; 417: 117085. DOI: 10.1016/j.jns.2020.117085Sharifian-Dorche M., Huot P., Osherov M., Wen D., Saveriano А., Giacomini P. Neurological complications of coronavirus infection; a comparative review and lessons learned during the COVID-19 pandemic. J Neurol Sci 2020; 417: 117085. DOI: 10.1016/j.jns.2020.117085Roy D., Ghosh R., Dubey S., Dubey M.J., Benito-León J., Ray B.K. et al. Neurological and Neuropsychiatric Impacts of COVID-19 Pandemic. Can J Neurol Sci 2021; 48(1): 9-24. DOI: 10.1017/cjn.2020.173Roy D., Ghosh R., Dubey S., Dubey M.J., Benito-León J., Ray B.K. et al. Neurological and Neuropsychiatric Impacts of COVID-19 Pandemic. Can J Neurol Sci 2021; 48(1): 9-24. DOI: 10.1017/cjn.2020.173Аbdel-Mannan O., Eyre M., Löbel U., Bamford A., Eltze С., Hameed B. et al. Neurologic and Radiographic Findings Associated With COVID-19 Infection in Children. JAMA Neurol 2020; 77(11): 1440-1445. DOI: 10.1001/jamaneurol.2020.2687Аbdel-Mannan O., Eyre M., Löbel U., Bamford A., Eltze С., Hameed B. et al. Neurologic and Radiographic Findings Associated With COVID-19 Infection in Children. JAMA Neurol 2020; 77(11): 1440-1445. DOI: 10.1001/jamaneurol.2020.2687Poyiadji N., Shahin G., Noujaim D., Stone M., Patel S., Griffith B. COVID-19-associated Acute Hemor-rhagic Necrotizing Encephalopathy: Imaging Features. Radiology 2020; 296(2): E119-E120. DOI: 10.1148/radiol.2020201187Poyiadji N., Shahin G., Noujaim D., Stone M., Patel S., Griffith B. COVID-19-associated Acute Hemor-rhagic Necrotizing Encephalopathy: Imaging Features. Radiology 2020; 296(2): E119-E120. DOI: 10.1148/radiol.2020201187Wong F., Simon E., Zimmerman R., Wang H., Toh C., Ngl S. Acute necrotizing encephalopathy of childhood: correlation of MR findings and clinical outcome. AJNR Am J Neuroradiol 2006; 27(9): 1919-1923Wong F., Simon E., Zimmerman R., Wang H., Toh C., Ngl S. Acute necrotizing encephalopathy of childhood: correlation of MR findings and clinical outcome. AJNR Am J Neuroradiol 2006; 27(9): 1919-1923Fedin A.I. Neurological clinical pathology associated with COVID-19. Neurology and neurosurgery. Eastern Europe 2020; 10(2): 312-329. DOI: 10.1016/S1474-4422(20)30221-0Fedin A.I. Neurological clinical pathology associated with COVID-19. Neurology and neurosurgery. Eastern Europe 2020; 10(2): 312-329. DOI: 10.1016/S1474-4422(20)30221-0Moriquchi T., Harii N., Goto J., Harada D., Sugawara H., Takaminoet J. et al. A first of meningitis/encephalitis associated with SARS-Coronavirus-2. International J Infect Dis 2020; 94: 54-58. DOI: 10.1016/j.ijid.2020.03.062Moriquchi T., Harii N., Goto J., Harada D., Sugawara H., Takaminoet J. et al. A first of meningitis/encephalitis associated with SARS-Coronavirus-2. International J Infect Dis 2020; 94: 54-58. DOI: 10.1016/j.ijid.2020.03.062Lindan C.E., Mankad K., Ram D., Kociolek L.К., Silvera V.M., Boddaertet N. et al., ASPNR PECOBIG Collaborator Group. Neuroimaging manifestations in children with SARSCoV-2 infection: a multinational, multicentre collaborative study. Lancet Child Adolesc Health 2021 ;5(3): 167-177. DOI: 10.1016/S2352-4642(20)30362-XLindan C.E., Mankad K., Ram D., Kociolek L.К., Silvera V.M., Boddaertet N. et al., ASPNR PECOBIG Collaborator Group. Neuroimaging manifestations in children with SARSCoV-2 infection: a multinational, multicentre collaborative study. Lancet Child Adolesc Health 2021 ;5(3): 167-177. DOI: 10.1016/S2352-4642(20)30362-XPascual-Goñi E., Fortea J., Martínez-Domeño A., Rabella N., Tecame М., Gómez-Olivaet С. et al. COVID19-associated ophthalmoparesis and hypothalamic involvement. Neurol Neuroimmunol Neuroinflamm 2020; 7(5): e823. DOI: 10.1212/NXI.0000000000000823Pascual-Goñi E., Fortea J., Martínez-Domeño A., Rabella N., Tecame М., Gómez-Olivaet С. et al. COVID19-associated ophthalmoparesis and hypothalamic involvement. Neurol Neuroimmunol Neuroinflamm 2020; 7(5): e823. DOI: 10.1212/NXI.0000000000000823Dinkin M., Gao V., Kahan J. Bobker S., Simonetto М., Wechsler Р. et al. COVID-19 presenting with ophthalmoparesis from cranial nerve palsy. Neurology 2020; 95(5): 221-223. DOI: 10.1212/WNL.0000000000009700Dinkin M., Gao V., Kahan J. Bobker S., Simonetto М., Wechsler Р. et al. COVID-19 presenting with ophthalmoparesis from cranial nerve palsy. Neurology 2020; 95(5): 221-223. DOI: 10.1212/WNL.0000000000009700Fernández-Domínguez J., Аmeijide-Sanluis Е., García-Cabo С., García-Rodríguez R., Mateos V. Miller-Fisher-like syndrome related to SARS-CoV-2 infection (COVID 19). Neurol 2020; 267(9): 2495-2496. DOI: 10.1007/s00415-020-09912-2Fernández-Domínguez J., Аmeijide-Sanluis Е., García-Cabo С., García-Rodríguez R., Mateos V. Miller-Fisher-like syndrome related to SARS-CoV-2 infection (COVID 19). Neurol 2020; 267(9): 2495-2496. DOI: 10.1007/s00415-020-09912-2Lantos J.E., Strauss S.B., Lin E. COVID-19-Associated Miller Fisher Syndrome: MRI Findings. AJNR Am J Neuroradiol 2020; 41(7): 1184-1186. DOI: 10.3174/ajnr.A6609Lantos J.E., Strauss S.B., Lin E. COVID-19-Associated Miller Fisher Syndrome: MRI Findings. AJNR Am J Neuroradiol 2020; 41(7): 1184-1186. DOI: 10.3174/ajnr.A6609Ray A. Miller Fisher syndrome and COVID-19: is there a link? BMJ Case Reports 2020; 13(8): e236419. DOI: 10.1136/bcr-2020-236419Ray A. Miller Fisher syndrome and COVID-19: is there a link? BMJ Case Reports 2020; 13(8): e236419. DOI: 10.1136/bcr-2020-236419Жаркова М.С., Тихонов И.Н., Ефремова И.В., Ондос С.А., Надинская М.Ю., Ивашкин В.Т. Изолированная битемпоральная гемианопсия у пациента с COVID-19. Сеченовский вестник 2020; 11(2): 92-98. DOI: 10.47093/2218-7332.2020.11.2.92-98Zharkova M.S., Tikhonov I.N., Efremova I.V., Ondos Sh.A., Nadinskaya M.Yu., Ivashkin V.T. Isolated bitemporal hemianopsia in a patient with COVID-19 infection. Sechenovsky Vestnik 2020; 11(2): 92-98. (in Russ.) DOI: 10.47093/2218-7332.2020.11.2.92-98Mao L., Wang М., Chen S., Hu Y., Chen S., He Q. et al. Neurological Manifestations of Hospitalized Patients with COVID-19 in Wuhan, China: a retrospective case series. JAMA Neurol 2020; 77(6): 683-690. DOI: 10.1001/jamaneurol.2020.1127Mao L., Wang М., Chen S., Hu Y., Chen S., He Q. et al. Neurological Manifestations of Hospitalized Patients with COVID-19 in Wuhan, China: a retrospective case series. JAMA Neurol 2020; 77(6): 683-690. DOI: 10.1001/jamaneurol.2020.1127Yachou Y., Idrissi A. El., Belapasov V., Ait Benali S. Neuroinvasion, neuro-tropic, and neuroinflammatory events of SARS-CoV-2: understanding the neurological manifestations in COVID-19 patients. Neurol Sci 2020; 41(10): 2657- 2669. DOI: 10.1007/s10072-020-04575-3Yachou Y., Idrissi A. El., Belapasov V., Ait Benali S. Neuroinvasion, neuro-tropic, and neuroinflammatory events of SARS-CoV-2: understanding the neurological manifestations in COVID-19 patients. Neurol Sci 2020; 41(10): 2657- 2669. DOI: 10.1007/s10072-020-04575-3Águila-Gordo D., Flores-Barragán J.M., Ferragut-Lloret F., Portela-Gutierrez J., LaRosa-Salas B., Porras-Leal L. et al. Acute mye-litis and SARS-CoV-2 infection. A new etiology of myelitis? J Clin Neurosci 2020; 80: 280-281. DOI: 10.1016/j.jocnÁguila-Gordo D., Flores-Barragán J.M., Ferragut-Lloret F., Portela-Gutierrez J., LaRosa-Salas B., Porras-Leal L. et al. Acute mye-litis and SARS-CoV-2 infection. A new etiology of myelitis? J Clin Neurosci 2020; 80: 280-281. DOI: 10.1016/j.jocnLindan C.E., Mankad K., Ram D., Kociolek L.K., Silvera V.M., Boddaert N. et al. ASPNR PECOBIG Collaborator Group. Neuroimaging manifestations in children with SARSCoV-2 infection: a multinational, multicentre collaborative study. Lancet Child Adolesc Health 2021; 5(3): 167-177. DOI: 10.1016/S2352-4642(20)30362-XLindan C.E., Mankad K., Ram D., Kociolek L.K., Silvera V.M., Boddaert N. et al. ASPNR PECOBIG Collaborator Group. Neuroimaging manifestations in children with SARSCoV-2 infection: a multinational, multicentre collaborative study. Lancet Child Adolesc Health 2021; 5(3): 167-177. DOI: 10.1016/S2352-4642(20)30362-XАстапов А.А., Кудин А.П., Ясинская Л.И. Энцефалиты у детей. Минск; БГМУ, 2018; 46.Astapov A.A., Kudin A.P., Yasinskaya L.I. Encephalitis in children. Minsk; BGMU, 2018; 46. (in Russ.)Методические рекомендации «Особенности клинических проявлений и лечения заболевания, вызванного новой коронавирусной инфекцией (COVID-19) у детей. Версия 2» (утверждены Министерством здравоохранения Российской Федерации 03.07.2020). https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/050/914/original/03062020_дети_COVID-19_v2.pdfMethodical recommendations «Features of clinical manifestations and treatment of disease caused by a new coronavirus infection (COVID-19) in children. Version 2» (approved by the Ministry of Health of the Russian Federation on 03.07.2020) (in Russ.) https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/050/914/original/03062020_дети_COVID-19_v2.pdfKogan E.A., Berezovsky Y.S., Protsenko D.D. Baghdasaryan T. R., Gretzov E. M., Demura S.A. et al. Pathological anatomy of infection caused by SARS-CoV-2. Forensic Medicine 2020; 6(2): 8-30. DOI: 10.19048/2411-8729-2020-6- 2-8-30Kogan E.A., Berezovsky Y.S., Protsenko D.D. Baghdasaryan T. R., Gretzov E. M., Demura S.A. et al. Pathological anatomy of infection caused by SARS-CoV-2. Forensic Medicine 2020; 6(2): 8-30. DOI: 10.19048/2411-8729-2020-6- 2-8-30Williamson E., Walker А., Bhaskaran К., Bacon S., Bates C., Mortonet C. et al. Factors associated with COVID-19-related death using Open SAFELY 2020; 584(7821): 430-436. DOI: 10.1038/s41586-020-2521-4Williamson E., Walker А., Bhaskaran К., Bacon S., Bates C., Mortonet C. et al. Factors associated with COVID-19-related death using Open SAFELY 2020; 584(7821): 430-436. DOI: 10.1038/s41586-020-2521-4Ray S.T.J., Abdel-Mannan O., Sa M., Slater R., Forgeron P., Palermo T. et al. CoroNerve study group. Lancet Child Adolesc Health 2021; 5(9): 631-641. DOI: 10.1016/S2352-4642(21)00193-0Ray S.T.J., Abdel-Mannan O., Sa M., Slater R., Forgeron P., Palermo T. et al. CoroNerve study group. Lancet Child Adolesc Health 2021; 5(9): 631-641. DOI: 10.1016/S2352-4642(21)00193-0

The authors declare that there are no conflicts of interest present.