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.