The recent Coronovirus [severe acute respiratory syndrome (SARS)-CoV-2] is associated with high morbidity and mortality, known as COVID-19, primarily due to the release of pro-inflammatory cytokines, especially IL-6, in the lungs. There is increasing evidence that COVID-19 also results in mental and neurologic symtpoms. Recent publications have also reported the presence of Multisystem Inflammatory Syndrome in children (MIS-C). SARS)-CoV-2 and/or the associated cytokines could enter the brain from the upper respiratory system, especially via the nose that communicates directly with the brain, resulting in Pediatric Acute Neuropsychiatric Syndrome (PANS) or Autism Spectrum Disorder (ASD), which involve activated microglia. These disorders also involve activation of mast cells, which can be triggered by viruses and secrete multiple cytokines including IL-1 and IL-6, thus potentially contributing to the pulmonary and neurologic symptoms of COVID-19. It will be important to design longitudinal studies to investigate the prevalence of ASD in children who were positive for COVID-19, and consider reducing inflammation of the brain as a prophylactic intervention.
