tetano
Editor, Senior Moderator
Pediatr Neurol
. 2023 Jul 22;147:130-138.
doi: 10.1016/j.pediatrneurol.2023.07.012. Online ahead of print. Chronic Neurological Disorders and Predisposition to Severe COVID-19 in Pediatric Patients in the United States
Megan Chi[SUP] 1 [/SUP], Olivia Heutlinger[SUP] 2 [/SUP], Carly Heffernan[SUP] 2 [/SUP], Terence Sanger[SUP] 3 [/SUP], Rachel Marano[SUP] 4 [/SUP], William Feaster[SUP] 4 [/SUP], Sharief Taraman[SUP] 3 [/SUP], Louis Ehwerhemuepha[SUP] 5 [/SUP]
Affiliations
Background: We investigated the association between chronic pediatric neurological conditions and the severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Methods: This matched retrospective case-control study includes patients (n = 71,656) with chronic complex neurological disorders under 18 years of age, with laboratory-confirmed diagnosis of COVID-19 or a diagnostic code indicating infection or exposure to SARS-CoV-2, from 103 health systems in the United States. The primary outcome was the severity of coronavirus disease 2019 (COVID-19), which was classified as severe (invasive oxygen therapy or death), moderate (noninvasive oxygen therapy), or mild/asymptomatic (no oxygen therapy). A cumulative link mixed effects model was used for this study.
Results: In this study, a cumulative link mixed effects model (random intercepts for health systems and patients) showed that the following classes of chronic neurological disorders were associated with higher odds of severe COVID-19: muscular dystrophies and myopathies (OR = 3.22; 95% confidence interval [CI]: 2.73 to 3.84), chronic central nervous system disorders (OR = 2.82; 95% CI: 2.67 to 2.97), cerebral palsy (OR = 1.97; 95% CI: 1.85 to 2.10), congenital neurological disorders (OR = 1.86; 95% CI: 1.75 to 1.96), epilepsy (OR = 1.35; 95% CI: 1.26 to 1.44), and intellectual developmental disorders (OR = 1.09; 95% CI: 1.003 to 1.19). Movement disorders were associated with lower odds of severe COVID-19 (OR = 0.90; 95% CI: 0.81 to 0.99).
Conclusions: Pediatric patients with chronic neurological disorders are at higher odds of severe COVID-19. Movement disorders were associated with lower odds of severe COVID-19.
Keywords: COVID-19; Children; Chronic complex pediatric neurological conditions; Critical care.
. 2023 Jul 22;147:130-138.
doi: 10.1016/j.pediatrneurol.2023.07.012. Online ahead of print. Chronic Neurological Disorders and Predisposition to Severe COVID-19 in Pediatric Patients in the United States
Megan Chi[SUP] 1 [/SUP], Olivia Heutlinger[SUP] 2 [/SUP], Carly Heffernan[SUP] 2 [/SUP], Terence Sanger[SUP] 3 [/SUP], Rachel Marano[SUP] 4 [/SUP], William Feaster[SUP] 4 [/SUP], Sharief Taraman[SUP] 3 [/SUP], Louis Ehwerhemuepha[SUP] 5 [/SUP]
Affiliations
- PMID: 37611407
- DOI: 10.1016/j.pediatrneurol.2023.07.012
Background: We investigated the association between chronic pediatric neurological conditions and the severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Methods: This matched retrospective case-control study includes patients (n = 71,656) with chronic complex neurological disorders under 18 years of age, with laboratory-confirmed diagnosis of COVID-19 or a diagnostic code indicating infection or exposure to SARS-CoV-2, from 103 health systems in the United States. The primary outcome was the severity of coronavirus disease 2019 (COVID-19), which was classified as severe (invasive oxygen therapy or death), moderate (noninvasive oxygen therapy), or mild/asymptomatic (no oxygen therapy). A cumulative link mixed effects model was used for this study.
Results: In this study, a cumulative link mixed effects model (random intercepts for health systems and patients) showed that the following classes of chronic neurological disorders were associated with higher odds of severe COVID-19: muscular dystrophies and myopathies (OR = 3.22; 95% confidence interval [CI]: 2.73 to 3.84), chronic central nervous system disorders (OR = 2.82; 95% CI: 2.67 to 2.97), cerebral palsy (OR = 1.97; 95% CI: 1.85 to 2.10), congenital neurological disorders (OR = 1.86; 95% CI: 1.75 to 1.96), epilepsy (OR = 1.35; 95% CI: 1.26 to 1.44), and intellectual developmental disorders (OR = 1.09; 95% CI: 1.003 to 1.19). Movement disorders were associated with lower odds of severe COVID-19 (OR = 0.90; 95% CI: 0.81 to 0.99).
Conclusions: Pediatric patients with chronic neurological disorders are at higher odds of severe COVID-19. Movement disorders were associated with lower odds of severe COVID-19.
Keywords: COVID-19; Children; Chronic complex pediatric neurological conditions; Critical care.