Clinical characteristics of SARS-CoV-2-associated encephalopathy in children: Nationwide epidemiological study.
J Neurol Sci
; 457: 122867, 2024 Feb 15.
Article
em En
| MEDLINE
| ID: mdl-38199023
ABSTRACT
OBJECTIVE:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sometimes triggers acute encephalopathy as a serious neurological complication in children. We previously reported the clinico-radiological findings of SARS-CoV-2-associated encephalopathy. The advent of the SARS-CoV-2 omicron variant led to a marked increase in pediatric patients with coronavirus disease 2019 (COVID-19); however, epidemiological changes with acute encephalopathy according to the emergence of SARS-CoV-2 have not yet been documented. Therefore, the present study investigated epidemiological differences in SARS-CoV-2-associated encephalopathy during the BA.1/BA.2 and BA.5 predominant periods and also between SARS-CoV-2-associated and non-SARS-CoV-2-associated encephalopathy.METHODS:
We conducted a nationwide survey of SARS-CoV-2-associated encephalopathy in Japanese children between June and November 2022. We compared the present results during the BA.5 predominant period and previous findings during the BA.1/BA.2 predominant period. We also compared the clinico-radiological syndromes of encephalopathy between SARS-CoV-2-associated and non-SARS-CoV-2-associated encephalopathy.RESULTS:
Although many patients with SARS-CoV-2-associated encephalopathy in the BA.5 predominant period had seizures as their initial symptoms, no significant differences were observed in the clinical features. Patients with SARS-CoV-2-associated encephalopathy had worse outcomes than those with non-SARS-CoV-2-associated encephalopathy (p-value = 0.003). Among 103 patients with SARS-CoV-2-associated encephalopathy, 14 (13.6%) had severe types of acute encephalopathy, namely, encephalopathy with acute fulminant cerebral edema (AFCE) and hemorrhagic shock and encephalopathy syndrome (HSES). Also, 28 (27.2%) patients with SARS-CoV-2-associated encephalopathy had pooroutcome:
severe neurological sequelae or death. Ninety-five patients (92.2%) were not vaccinated against SARS-CoV-2.CONCLUSIONS:
In SARS-CoV-2-associated encephalopathy, high percentages of AFCE and HSES can result in poor outcomes.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Choque Hemorrágico
/
Transtornos da Coagulação Sanguínea
/
Encefalopatias
/
COVID-19
Tipo de estudo:
Risk_factors_studies
Limite:
Child
/
Humans
Idioma:
En
Revista:
J Neurol Sci
Ano de publicação:
2024
Tipo de documento:
Article