학술논문
Neurological involvement in hospitalized children with SARS-CoV-2 infection: a multinational study.
Document Type
Academic Journal
Author
Yea C; Neuroscience and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada.; Barton M; Department of Pediatrics, University of Western Ontario, London, Ontario, Canada.; Bitnun A; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.; Division of Infectious Diseases, The Hospital for Sick Children, Toronto, Ontario, Canada.; Morris SK; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.; Division of Infectious Diseases, The Hospital for Sick Children, Toronto, Ontario, Canada.; El Tal T; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada.; Ulloa-Gutierrez R; Department of Pediatrics, Hospital Nacional de Niños 'Dr. Carlos Sáenz Herrera', Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica.; Brenes-Chacon H; Department of Pediatrics, Hospital Nacional de Niños 'Dr. Carlos Sáenz Herrera', Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica.; Yock-Corrales A; Department of Pediatrics, Hospital Nacional de Niños 'Dr. Carlos Sáenz Herrera', Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica.; Ivankovich-Escoto G; Department of Pediatrics, Hospital Nacional de Niños 'Dr. Carlos Sáenz Herrera', Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica.; Soriano-Fallas A; Department of Pediatrics, Hospital Nacional de Niños 'Dr. Carlos Sáenz Herrera', Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica.; Hernandez-de Mezerville M; Department of Pediatrics, Hospital Nacional de Niños 'Dr. Carlos Sáenz Herrera', Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica.; Gill P; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.; Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.; Nateghian A; Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran.; Aski BH; Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran.; Manafi AA; Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran.; Dwilow R; Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada.; Bullard J; Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada.; Papenburg J; Division of Pediatric Infectious Diseases, Dept. of Pediatrics, Montreal Children's Hospital (McGill University Health Centre), Montreal, Quebec, Canada.; Division of Microbiology, Dept. of Clinical Laboratory Medicine, Optilab Montreal, McGill University Health Centre, Montreal, Quebec, Canada.; Scuccimarri R; Division of Rheumatology, Montreal Children's Hospital (McGill University Health Centre), Montreal, Quebec, Canada.; Lefebvre MA; Division of Pediatric Infectious Diseases, Dept. of Pediatrics, Montreal Children's Hospital (McGill University Health Centre), Montreal, Quebec, Canada.; Cooke S; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.; Dewan T; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.; Restivo L; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.; Lopez A; BC Children's Hospital, Vancouver, BC, Canada.; Sadarangani M; BC Children's Hospital, Vancouver, BC, Canada.; Vaccine Evaluation Center, University of British Columbia, Vancouver, BC, Canada.; Roberts A; BC Children's Hospital, Vancouver, BC, Canada.; Wong J; Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.; Saux NL; Department of Pediatrics, University of Ottawa, Ontario, Canada.; Bowes J; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.; Purewal R; Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.; Lautermilch J; Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.; Foo C; Department of Pediatrics, Memorial University, St. John's, Newfoundland and Labrador, Canada.; Merckx J; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.; Robinson J; Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.; Yeh EA; Neuroscience and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada.; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.; Division of Neurology, The Hospital of Sick Children, Toronto, Ontario, Canada.
Source
Publisher: published by Cambridge University Press for the Canadian Neurological Sciences Federation Country of Publication: England NLM ID: 0415227 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0317-1671 (Print) Linking ISSN: 03171671 NLM ISO Abbreviation: Can J Neurol Sci Subsets: MEDLINE
Subject
Language
English
ISSN
0317-1671
Abstract
Background and Objectives: Neurological involvement associated with SARS-CoV-2 infection is increasingly recognized. However, the specific characteristics and prevalence in pediatric patients remain unclear. The objective of this study was to describe the neurological involvement in a multinational cohort of hospitalized pediatric patients with SARS-CoV-2.
Methods: This was a multicenter observational study of children <18 years of age with confirmed SARS-CoV-2 infection or multisystemic inflammatory syndrome (MIS-C) and laboratory evidence of SARS-CoV-2 infection in children, admitted to 15 tertiary hospitals/healthcare centers in Canada, Costa Rica, and Iran February 2020-May 2021. Descriptive statistical analyses were performed and logistic regression was used to identify factors associated with neurological involvement.
Results: One-hundred forty-seven (21%) of 697 hospitalized children with SARS-CoV-2 infection had neurological signs/symptoms. Headache ( n = 103), encephalopathy ( n = 28), and seizures ( n = 30) were the most reported. Neurological signs/symptoms were significantly associated with ICU admission (OR: 1.71, 95% CI: 1.15-2.55; p = 0.008), satisfaction of MIS-C criteria (OR: 3.71, 95% CI: 2.46-5.59; p < 0.001), fever during hospitalization (OR: 2.15, 95% CI: 1.46-3.15; p < 0.001), and gastrointestinal involvement (OR: 2.31, 95% CI: 1.58-3.40; p < 0.001). Non-headache neurological manifestations were significantly associated with ICU admission (OR: 1.92, 95% CI: 1.08-3.42; p = 0.026), underlying neurological disorders (OR: 2.98, 95% CI: 1.49-5.97, p = 0.002), and a history of fever prior to hospital admission (OR: 2.76, 95% CI: 1.58-4.82; p < 0.001).
Discussion: In this study, approximately 21% of hospitalized children with SARS-CoV-2 infection had neurological signs/symptoms. Future studies should focus on pathogenesis and long-term outcomes in these children.
Methods: This was a multicenter observational study of children <18 years of age with confirmed SARS-CoV-2 infection or multisystemic inflammatory syndrome (MIS-C) and laboratory evidence of SARS-CoV-2 infection in children, admitted to 15 tertiary hospitals/healthcare centers in Canada, Costa Rica, and Iran February 2020-May 2021. Descriptive statistical analyses were performed and logistic regression was used to identify factors associated with neurological involvement.
Results: One-hundred forty-seven (21%) of 697 hospitalized children with SARS-CoV-2 infection had neurological signs/symptoms. Headache ( n = 103), encephalopathy ( n = 28), and seizures ( n = 30) were the most reported. Neurological signs/symptoms were significantly associated with ICU admission (OR: 1.71, 95% CI: 1.15-2.55; p = 0.008), satisfaction of MIS-C criteria (OR: 3.71, 95% CI: 2.46-5.59; p < 0.001), fever during hospitalization (OR: 2.15, 95% CI: 1.46-3.15; p < 0.001), and gastrointestinal involvement (OR: 2.31, 95% CI: 1.58-3.40; p < 0.001). Non-headache neurological manifestations were significantly associated with ICU admission (OR: 1.92, 95% CI: 1.08-3.42; p = 0.026), underlying neurological disorders (OR: 2.98, 95% CI: 1.49-5.97, p = 0.002), and a history of fever prior to hospital admission (OR: 2.76, 95% CI: 1.58-4.82; p < 0.001).
Discussion: In this study, approximately 21% of hospitalized children with SARS-CoV-2 infection had neurological signs/symptoms. Future studies should focus on pathogenesis and long-term outcomes in these children.