New-Onset Dizziness Associated With COVID-19.

As data accumulate during the COVID-19 pandemic, SARS-CoV-2 has been shown to induce various neurological problems. Focal status epilepticus and encephalopathy were reported as the presenting symptoms in a nine-year-old boy by Swarz et al. We report two children with confirmed COVID-19 infection who presented with dizziness. Both were in good medical condition prior to the infection, and vital signs were within normal limits. The first child was a 12-year-old girl who was admitted to the hospital with fever, cough, headache, and dizziness. Physical and comprehensive neurological examination was normal other than crackles in the lung bases. Complete blood cell counts, C-reactive protein, electrolytes, liver and kidney function tests, coagulation parameters, electrocardiogram, and chest X-ray were within normal limits. On the second day of admission, she experienced nausea, bloody vomiting, and tachypnea. Vomiting continued for three days. She was discharged after seven days of hospitalization in good medical condition with a good appetite. The second patient was a 13-year-old boy who was admitted to the emergency department with complaints of headache, dizziness, and fever. His physical and neurological examination was unremarkable except for pharyngeal erythema. His laboratory parameters were within normal limits. Chest X-ray revealed unilateral patchy infiltrates, and he was treated as an outpatient with cefdinir, hydroxychloroquine, and oseltamivir for five days. Headache and dizziness resolved within a week in both patients.

Human coronaviruses may enter the central nervous system through the hematogenous or neuronal retrograde route. There is little information about headache or dizziness in children with a COVID-19 infection. Wu et al. reported headache and dizziness in 2.7% and 0% of pediatric patients. Three of 31 children presented with headache or dizziness in another report.

Encephalopathy, headache, dysarthria, dysphagia, meningism, cerebellar ataxia, axial hypotonia, and drowsiness have been associated with COVID-19 in children. , , Patients with severe COVID-19 were more likely to develop neurological and cerebrovascular complications. The presence of dizziness suggests the need for a comprehensive neurological examination. Early diagnosis is essential to avoid the dissemination of the disease.