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.