tetano
Editor, Senior Moderator
Pediatr Neurol
. 2024 Jan 11:153:68-76.
doi: 10.1016/j.pediatrneurol.2024.01.008. Online ahead of print. A Systematic Review and Clinical Presentation of Central Nervous System Complications of Severe Acute Respiratory Syndrome Coronavirus 2 in Hospitalized Pediatric Patients During the Coronavirus Disease 2019 Pandemic in Israel
Menucha Jurkowicz[SUP] 1 [/SUP], Eugene Leibovitz[SUP] 2 [/SUP], Bruria Ben-Zeev[SUP] 3 [/SUP], Nathan Keller[SUP] 4 [/SUP], Or Kriger[SUP] 2 [/SUP], Gilad Sherman[SUP] 2 [/SUP], Sharon Amit[SUP] 5 [/SUP], Galia Barkai[SUP] 2 [/SUP], Michal Mandelboim[SUP] 6 [/SUP], Michal Stein[SUP] 7 [/SUP]
Affiliations
Background: Coronavirus disease-associated central nervous system complications (CNS-C) in hospitalized children, especially during the Omicron wave, and in comparison with influenza associated CNS-C, are not well understood.
Methods: The study population included 755 children aged <18 years hospitalized with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at Sheba Medical Center, during March 2020 to July 2022. A comparative cohort consisted of 314 pediatric patients with influenza during the 2018-2019 and 2019-2020 influenza seasons.
Results: Overall, 5.8% (n = 44) of patients exhibited CNS-C. Seizures at presentation occurred in 33 patients with COVID-19 (4.4%), with 2.6% (n = 20) experiencing nonfebrile seizures, 1.1% (n = 8) febrile seizures, and 0.7% (n = 5) status epilepticus. More patients with CNS-C experienced seizures during the Omicron wave versus the pre-Omicron period (77.8% vs 41.2%, P = 0.03). Fewer patients were admitted to the intensive care unit in the Omicron wave (7.4%) versus prior waves (7.4% vs 41.2%, P = 0.02). Fewer patients with SARS-CoV-2 experienced CNS-C (5.8%) versus patients with influenza (9.9%), P = 0.03. More patients with SARS-CoV-2 experienced nonfebrile seizures (2.6% vs 0.6%, P = 0.06), whereas more patients with influenza experienced febrile seizures (7.3% vs 1.1%, P < 0.01).
Conclusions: The Omicron wave was characterized by more seizures and fewer intensive-care-unit admissions than previous waves. Pediatric patients with SARS-CoV-2 experienced fewer CNS-C and more nonfebrile seizures compared with patients with influenza.
Keywords: Central nervous system; Infectious diseases; Influenza; Neurological; Pediatrics; SARS-CoV-2.
. 2024 Jan 11:153:68-76.
doi: 10.1016/j.pediatrneurol.2024.01.008. Online ahead of print. A Systematic Review and Clinical Presentation of Central Nervous System Complications of Severe Acute Respiratory Syndrome Coronavirus 2 in Hospitalized Pediatric Patients During the Coronavirus Disease 2019 Pandemic in Israel
Menucha Jurkowicz[SUP] 1 [/SUP], Eugene Leibovitz[SUP] 2 [/SUP], Bruria Ben-Zeev[SUP] 3 [/SUP], Nathan Keller[SUP] 4 [/SUP], Or Kriger[SUP] 2 [/SUP], Gilad Sherman[SUP] 2 [/SUP], Sharon Amit[SUP] 5 [/SUP], Galia Barkai[SUP] 2 [/SUP], Michal Mandelboim[SUP] 6 [/SUP], Michal Stein[SUP] 7 [/SUP]
Affiliations
- PMID: 38335916
- DOI: 10.1016/j.pediatrneurol.2024.01.008
Background: Coronavirus disease-associated central nervous system complications (CNS-C) in hospitalized children, especially during the Omicron wave, and in comparison with influenza associated CNS-C, are not well understood.
Methods: The study population included 755 children aged <18 years hospitalized with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at Sheba Medical Center, during March 2020 to July 2022. A comparative cohort consisted of 314 pediatric patients with influenza during the 2018-2019 and 2019-2020 influenza seasons.
Results: Overall, 5.8% (n = 44) of patients exhibited CNS-C. Seizures at presentation occurred in 33 patients with COVID-19 (4.4%), with 2.6% (n = 20) experiencing nonfebrile seizures, 1.1% (n = 8) febrile seizures, and 0.7% (n = 5) status epilepticus. More patients with CNS-C experienced seizures during the Omicron wave versus the pre-Omicron period (77.8% vs 41.2%, P = 0.03). Fewer patients were admitted to the intensive care unit in the Omicron wave (7.4%) versus prior waves (7.4% vs 41.2%, P = 0.02). Fewer patients with SARS-CoV-2 experienced CNS-C (5.8%) versus patients with influenza (9.9%), P = 0.03. More patients with SARS-CoV-2 experienced nonfebrile seizures (2.6% vs 0.6%, P = 0.06), whereas more patients with influenza experienced febrile seizures (7.3% vs 1.1%, P < 0.01).
Conclusions: The Omicron wave was characterized by more seizures and fewer intensive-care-unit admissions than previous waves. Pediatric patients with SARS-CoV-2 experienced fewer CNS-C and more nonfebrile seizures compared with patients with influenza.
Keywords: Central nervous system; Infectious diseases; Influenza; Neurological; Pediatrics; SARS-CoV-2.