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, Eugene Leibovitz, Bruria Ben-Zeev, Nathan Keller, Or Kriger, Gilad Sherman, Sharon Amit, Galia Barkai, Michal Mandelboim, Michal Stein

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)68-76
Number of pages9
JournalPediatric Neurology
Volume153
DOIs
StatePublished - 1 Apr 2024
Externally publishedYes

Keywords

  • Central nervous system
  • Infectious diseases
  • Influenza
  • Neurological
  • Pediatrics
  • SARS-CoV-2

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Developmental Neuroscience
  • Pediatrics, Perinatology, and Child Health

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