Post-COVID-19 neurogenic lower urinary tract dysfunction in pediatrics: A case series of clinical manifestations resembling Elsberg syndrome

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Abstract
Background: Among the numerous complications associated with post-coronavirus disease 2019 (COVID-19) syndrome, neurogenic lower urinary tract dysfunction (NLUTD) has been rarely reported, particularly in the pediatric population. Case Presentation: This report presented three pediatric cases of NLUTD that developed following severe acute respiratory syndrome coronavirus 2 infection, with clinical features resembling Elsberg syndrome. These cases were notable for the severity of their urinary symptoms, which required specialized and individualized bladder management strategies. This case series aims to raise awareness of this emerging clinical condition, which may be underdiagnosed in children recovering from COVID-19. Pediatricians, general practitioners, and urologists should be vigilant in considering NLUTD as a potential diagnosis in children presenting with new or unexplained urinary symptoms. Early diagnosis and timely management are crucial to address these symptoms effectively and prevent potential complications, such as irreversible upper urinary tract damage or long-term bladder dysfunction. Conclusion: Further investigations are warranted to clarify the pathophysiological mechanisms underlying post-COVID-19 NLUTD. Moreover, long-term follow-up studies are needed to better understand the natural history and implications of this condition in the pediatric population, as well as to develop effective strategies for prevention and treatment.

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