TY - JOUR
T1 - Prevalence and Risk Factors of Neurologic Manifestations in Hospitalized Children Diagnosed with Acute SARS-CoV-2 or MIS-C
AU - Global Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID) Investigators
AU - Fink, Ericka L.
AU - Robertson, Courtney L.
AU - Wainwright, Mark S.
AU - Roa, Juan D.
AU - Lovett, Marlina E.
AU - Stulce, Casey
AU - Yacoub, Mais
AU - Potera, Renee M.
AU - Zivick, Elizabeth
AU - Holloway, Adrian
AU - Nagpal, Ashish
AU - Wellnitz, Kari
AU - Czech, Theresa
AU - Even, Katelyn M.
AU - Brunow de Carvalho, Werther
AU - Rodriguez, Isadora Souza
AU - Schwartz, Stephanie P.
AU - Walker, Tracie C.
AU - Campos-Miño, Santiago
AU - Dervan, Leslie A.
AU - Geneslaw, Andrew S.
AU - Sewell, Taylor B.
AU - Pryce, Patrice
AU - Silver, Wendy G.
AU - Lin, Jieru Egeria
AU - Vargas, Wendy S.
AU - Topjian, Alexis
AU - Alcamo, Alicia M.
AU - McGuire, Jennifer L.
AU - Domínguez Rojas, Jesus Angel
AU - Muñoz, Jaime Tasayco
AU - Hong, Sue J.
AU - Muller, William J.
AU - Doerfler, Matthew
AU - Williams, Cydni N.
AU - Drury, Kurt
AU - Bhagat, Dhristie
AU - Nelson, Aaron
AU - Price, Dana
AU - Dapul, Heda
AU - Santos, Laura
AU - Kahoud, Robert
AU - Francoeur, Conall
AU - Appavu, Brian
AU - Guilliams, Kristin P.
AU - Agner, Shannon C.
AU - Walson, Karen H.
AU - Rasmussen, Lindsey
AU - Janas, Anna
AU - Ferrazzano, Peter
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/3
Y1 - 2022/3
N2 - Background: 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). Methods: 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. Results: 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. Conclusions: 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.
AB - Background: 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). Methods: 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. Results: 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. Conclusions: 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.
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U2 - 10.1016/j.pediatrneurol.2021.12.010
DO - 10.1016/j.pediatrneurol.2021.12.010
M3 - Article
C2 - 35066369
AN - SCOPUS:85122662722
SN - 0887-8994
VL - 128
SP - 33
EP - 44
JO - Pediatric Neurology
JF - Pediatric Neurology
ER -