Predictive value of inflammatory markers for convulsions in children infected with the severe acute respiratory syndrome coronavirus 2 Omicron variant

Xing LIAO; Ling WU; Rongrong YANG

ABSTRACT

Objective:

To explore the predictive value of inflammatory markers for convulsions in children infected with the severe acute respiratory syndrome coronavirus 2 Omicron variant.

Methods:

A total of 263 children infected with the Omicron variant admitted to various wards of Fujian Children′s Hospital from December 2022 to January 2023 were included in this study. Based on the presence or absence of convulsions, the children were divided into convulsions group (93 cases) and non-convulsions group (170 cases). Chi-square test and independent samples t-test were used to compare the clinical characteristics and laboratory indicators of the two groups. Binary logistic regression analysis was conducted to determine the relationship between inflammatory markers and convulsions, and receiver operator characteristic (ROC) curve was used to evaluate the efficacy of serum amyloid A (SAA) and interleukin-6 (IL-6) for predicting convulsions occurrence in children.

Results:

The convulsions group had proportions of 29.03%(27/93) with underlying medical conditions and 40.86%(38/93) with a history of febrile convulsions, which were both higher than the non-convulsions group′s proportions of 18.24%(31/170) and 5.29%(9/170), respectively. These differences were both statistically significant ( χ2=8.71 and 16.92, respectively, both P<0.05). In the convulsions group, levels of procalcitonin, serum ferritin, IL-6, SAA, aspartate aminotransferase, creatine kinase, creatine kinase-isoenzymes and fibrinogen were all significantly higher than those in the non-convulsions group. These differences were all statistically significant ( t=-2.00, -1.54, -2.71, -5.04, -1.30, -2.03, -1.38 and 1.57, respectively, all P<0.05). Erythrocyte sedimentation rate, C-reactive protein, lymphocyte count, blood urea nitrogen and serum creatinine in the convulsions group were all lower than those in the non-convulsions group, with statistically significant differences ( t=3.31, 2.05, 4.21, 2.37 and 1.85, respectively, all P<0.05). SAA and IL-6 were identified as independent risk factors for convulsions in children infected with Omicron variant (both P<0.01). The ROC curve analysis showed that the area under the curve of predictive value of combined SAA and IL-6 was 0.833 ( P<0.01), with a sensitivity of 0.724 and specificity of 0.843. The optimal cutoff values for SAA and IL-6 in predicting convulsions in children infected with the Omicron variant were 141.40 mg/L and 85.05 ng/L, respectively.

Conclusions:

The combination of SAA and IL-6 could serve as early predictive indicators for convulsions in children infected with the Omicron variant, which could provide valuable insights for timely clinical diagnosis and treatment.