Journal article
Prevalence and Risk Factors of Neurologic Manifestations in Hospitalized Children Diagnosed with Acute SARS-CoV-2 or MIS-C
Pediatric neurology, Vol.128, pp.33-44
03/2022
DOI: 10.1016/j.pediatrneurol.2021.12.010
PMCID: PMC8713420
PMID: 35066369
Abstract
Our objective was to characterize the frequency, early impact, and risk factors for neurological manifestations in hospitalized children with acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or multisystem inflammatory syndrome in children (MIS-C).
Multicenter, cross-sectional study of neurological manifestations in children aged <18 years hospitalized with positive SARS-CoV-2 test or clinical diagnosis of a SARS-CoV-2-related condition between January 2020 and April 2021. Multivariable logistic regression to identify risk factors for neurological manifestations was performed.
Of 1493 children, 1278 (86%) were diagnosed with acute SARS-CoV-2 and 215 (14%) with MIS-C. Overall, 44% of the cohort (40% acute SARS-CoV-2 and 66% MIS-C) had at least one neurological manifestation. The most common neurological findings in children with acute SARS-CoV-2 and MIS-C diagnosis were headache (16% and 47%) and acute encephalopathy (15% and 22%), both P < 0.05. Children with neurological manifestations were more likely to require intensive care unit (ICU) care (51% vs 22%), P < 0.001. In multivariable logistic regression, children with neurological manifestations were older (odds ratio [OR] 1.1 and 95% confidence interval [CI] 1.07 to 1.13) and more likely to have MIS-C versus acute SARS-CoV-2 (OR 2.16, 95% CI 1.45 to 3.24), pre-existing neurological and metabolic conditions (OR 3.48, 95% CI 2.37 to 5.15; and OR 1.65, 95% CI 1.04 to 2.66, respectively), and pharyngeal (OR 1.74, 95% CI 1.16 to 2.64) or abdominal pain (OR 1.43, 95% CI 1.03 to 2.00); all P < 0.05.
In this multicenter study, 44% of children hospitalized with SARS-CoV-2-related conditions experienced neurological manifestations, which were associated with ICU admission and pre-existing neurological condition. Posthospital assessment for, and support of, functional impairment and neuroprotective strategies are vitally needed.
Details
- Title: Subtitle
- Prevalence and Risk Factors of Neurologic Manifestations in Hospitalized Children Diagnosed with Acute SARS-CoV-2 or MIS-C
- Creators
- Ericka L. Fink - Children's Hospital of PittsburghCourtney L. Robertson - Johns Hopkins Children's CenterMark S. Wainwright - University of WashingtonJuan D. Roa - Fundación Universitaria de Ciencias de la SaludMarlina E. Lovett - The Ohio State UniversityCasey Stulce - University of ChicagoMais Yacoub - Division of Critical Care, Department of Pediatrics, UMC Children's Hospital, Las Vegas, NevadaRenee M. Potera - The University of Texas Southwestern Medical CenterElizabeth Zivick - Medical University of South CarolinaAdrian Holloway - University of Maryland Medical CenterAshish Nagpal - Department of Pediatrics, Section of Critical Care Medicine, Oklahoma Children's Hospital at OU health, Oklahoma University College of Medicine, Oklahoma City, OklahomaKari Wellnitz - University of IowaTheresa Czech - University of IowaKatelyn M. Even - Pennsylvania State UniversityWerther Brunow de Carvalho - Universidade de São PauloIsadora Souza Rodriguez - Universidade de São PauloStephanie P. Schwartz - University of North Carolina at Chapel HillTracie C. Walker - University of North Carolina at Chapel HillSantiago Campos-Miño - Hospital MetropolitanoLeslie A. Dervan - University of Washington School of MedicineAndrew S. Geneslaw - Columbia UniversityTaylor B. Sewell - Columbia UniversityPatrice Pryce - Columbia UniversityWendy G. Silver - Columbia UniversityJieru Egeria Lin - Columbia UniversityWendy S. Vargas - Columbia UniversityAlexis TopjianAlicia M. AlcamoJennifer L. McGuireJesus Angel Domínguez Rojas - Division of Pediatric Critical Care, Department of Pediatrics, Hospital de Emergencia Villa El Salvador, Lima, PeruJaime Tasayco Muñoz - Division of Pediatric Critical Care, Department of Pediatrics, Hospital de Emergencia Villa El Salvador, Lima, PeruSue J. Hong - Northwestern UniversityWilliam J. Muller - Northwestern UniversityMatthew Doerfler - Northwestern UniversityCydni N. Williams - Oregon Health & Science UniversityKurt Drury - Oregon Health & Science UniversityDhristie Bhagat - Department of Neurology, NYU Langone Health, New York, New YorkAaron Nelson - Department of Neurology, NYU Langone Health, New York, New YorkDana Price - Department of Neurology, NYU Langone Health, New York, New YorkHeda Dapul - Division of Pediatric Critical Care, Department of Pediatrics, Hassenfeld Children's Hospital at NYU Langone Health, New York, New YorkLaura Santos - Division of Pediatric Critical Care, Department of Pediatrics, Hassenfeld Children's Hospital at NYU Langone Health, New York, New YorkRobert Kahoud - Division of Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MinnesotaConall Francoeur - Université LavalBrian Appavu - University of ArizonaKristin P. Guilliams - Washington University in St. LouisShannon C. Agner - Washington University in St. LouisKaren H. Walson - Children's Healthcare of AtlantaLindsey Rasmussen - Stanford UniversityAnna Janas - Stanford UniversityPeter Ferrazzano - University of Wisconsin–MadisonRaquel Farias-Moeller - Medical College of WisconsinKellie C. Snooks - Medical College of WisconsinChung-Chou H. Chang - University of PittsburghJames Yun - University of PittsburghMichelle E. Schober - University of UtahGlobal Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID) Investigators
- Resource Type
- Journal article
- Publication Details
- Pediatric neurology, Vol.128, pp.33-44
- DOI
- 10.1016/j.pediatrneurol.2021.12.010
- PMID
- 35066369
- PMCID
- PMC8713420
- NLM abbreviation
- Pediatr Neurol
- ISSN
- 0887-8994
- eISSN
- 1873-5150
- Publisher
- Elsevier Inc
- Grant note
- DOI: 10.13039/100018373, name: Neurocritical Care Society
- Language
- English
- Date published
- 03/2022
- Academic Unit
- Critical Care; Stead Family Department of Pediatrics; Neurology (Pediatrics)
- Record Identifier
- 9984354039802771
Metrics
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