Infectious Disease

‘Surprising’ number of children hospitalized with COVID-19 have neurologic complications

August 16, 2022

2 min read

Source/Disclosures

Disclosures:
Antoon reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

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About 7% of children hospitalized with COVID-19 at major pediatric hospitals in the United States experienced a neurologic complication of some kind, even if they were otherwise healthy, a study in Pediatrics reported.

Co-author James W. Antoon, MD, PhD, MPH, an assistant professor of pediatrics and hospital medicine at Vanderbilt University Medical Center, told Healio that although it is well known that adults can have “serious neurologic conditions” associated with COVID-19 , “the data on kids [have] been pretty minimal.”

Anton, et al.

“There have been reports throughout the pandemic that children who have COVID-19 may experience neurologic complications,” Antoon said. “But when omicron emerged, there were numerous reports in the media — and then case reports in our literature — about acute neurologic complications in children that seem to be more prevalent than with previous variants. So, because of those reports, we decided to perform the study to better understand the relationship between COVID-19 in neurologic complications, and to determine how often these actually occur.”

In a cross-sectional study, Antoon and colleagues compared all children who were admitted and hospitalized with COVID-19 at 49 large children’s hospitals. They compared children who had a neurologic complication with children who did not have a neurologic complication, which they defined as having a diagnosis of encephalopathy, encephalitis, seizures, brain abscess, meningitis or stroke.

Ultimately, the researchers found that of the 15,137 hospitalizations included in the analysis, 1,060 (7%) had a neurologic complication, with the most common being febrile seizures (3.8%), nonfebrile seizures (2.3%) and encephalopathy (2.1%).

Antoon said 75% of children who had a neurologic complication did not have an underlying neurologic comorbidity, and 60% of the same group were otherwise healthy.

Children who had neurologic complications alongside COVID-19 also had uniformly worse outcomes than their peers without these conditions, and “were more likely to need ICU care, to have a prolonged hospital stay and have higher hospital costs,” Antoon said.

“This prevalence of neurologic complications is similar to what we see with influenza, and more than what we see in other viruses and children,” Antoon said. “So, the prevalence was a little bit surprising [and] the number of healthy children who had this occur was somewhat unexpected.”

Antoon said the best way to prevent these complications would be to prevent COVID-19 itself “through vaccination, and other mitigation efforts.”

“Early recognition and treatment of these complications may help improve outcomes for these kids,” Antoon said.

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