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“To the Editor” COVID19-associated unilateral transient phrenic nerve palsy in a young child with respiratory failure
  • +7
  • Pierre Goussard,
  • Regan Solomons,
  • Magriet van Niekerk,
  • Noor Parker,
  • Carien Bekker,
  • Andre Gie,
  • M Van der Zalm,
  • Savvas Andronikou,
  • Helena Rabie,
  • Ronald van Toorn
Pierre Goussard
Stellenbosch University Faculty of Medicine and Health Sciences
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Regan Solomons
Stellenbosch University Faculty of Medicine and Health Sciences
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Magriet van Niekerk
Stellenbosch University Faculty of Medicine and Health Sciences
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Noor Parker
Stellenbosch University Faculty of Medicine and Health Sciences
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Carien Bekker
Stellenbosch University Faculty of Medicine and Health Sciences
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Andre Gie
Stellenbosch University Faculty of Medicine and Health Sciences
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M Van der Zalm
Stellenbosch University Faculty of Medicine and Health Sciences
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Savvas Andronikou
Department of Pediatric Radiology The Children's Hospital of Philadelphia Philadelphia Pennsylvania USA
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Helena Rabie
Stellenbosch University Faculty of Medicine and Health Sciences
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Ronald van Toorn
Stellenbosch University Faculty of Medicine and Health Sciences
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Abstract

We describe a case of unilateral phrenic nerve palsy due to SARS-COV-2 in a young child, which led to prolonged and complicated ventilation. The child was treated with methylprednisolone and IVIG, which led to a complete recovery of phrenic function. Temporary involvement of the phrenic nerve should be considered in children infected with SARS-COV-2 requiring prolonged ventilation. The phrenic nerve palsy is postulated to be due to peripheral nerve involvement by SARS-CoV-2. In South Africa, children under 12 years of age are not prioritized for SARS-CoV-2 vaccination. This case re-iterates that even though SARS-CoV-2 disease is mild in the vast majority of children there are more severe presentations which, in low- or middle-income countries, might even go unrecognized.