tetano
Editor, Senior Moderator
Pediatr Res
. 2023 Nov 21.
doi: 10.1038/s41390-023-02904-8. Online ahead of print. Children with severe neurological symptoms associated with SARS-CoV-2 infection during Omicron pandemic in China
Tao Zhang[SUP] 1 [/SUP], Qiao-Feng Zhang[SUP] 2 [/SUP], Hong-Mei Yang[SUP] 2 [/SUP], Pin Liu[SUP] 3 [/SUP], Peng Sun[SUP] 3 [/SUP], Yu-Mei Li[SUP] 4 [/SUP], Zhen Zhang[SUP] 4 [/SUP], Yan-Zhi Huang[SUP] 5 [/SUP], Xin-Yan Yu[SUP] 6 [/SUP], Qi-Qi-Ge Chao-Lu-Men[SUP] 7 [/SUP], Qin Su[SUP] 7 [/SUP], Chun-Feng Liu[SUP] 8 [/SUP]
Affiliations
Background: To analyze the clinical characteristics and outcomes of children with severe neurological symptoms associated with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during the Omicron pandemic in China.
Methods: This study used a questionnaire to obtain data from pediatric intensive care unit (PICU) centers in seven tertiary hospitals in Northeast China from December 1, 2022, to January 31, 2023.
Results: A total of 255 patients were confirmed to have SARS-CoV-2 infection, and 45 patients (17.65 %) were included in this study. Of these, seven (15.6%) patients died, and the median time from admission to death was 35 h (IQR, 14-120 h). Twenty (52.6%) survivors experienced neurological sequelae. Patients with platelet counts lower than 100 × 10[SUP]9[/SUP]/L had a higher incidence of complications such as multiple organ dysfunction, mechanical ventilation rate, and mortality. Cranial magnetic resonance imaging (MRI) always reveals cerebral tissue edema, with some severe lesions forming a softening site.
Conclusion: Children infected with SARS-CoV-2 often exhibit severe neurological symptoms, and in some cases, they may rapidly develop malignant cerebral edema or herniation, leading to a fatal outcome. An early decrease in platelet count may associated with an unfavorable prognosis.
Impact: Since early December 2022, China has gradually adjusted its prevention and control policy of SARS-CoV-2; Omicron outbreaks have occurred in some areas for a relatively short period. Due to the differences in ethnicity, endemic strains and vaccination status, there was a little difference from what has been reported about children with SARS-CoV-2 infection with severe neurological symptoms in abroad. This is the first multicenter clinical study in children with nervous system involvement after acute SARS-CoV-2 infection in China, and helpful for pediatricians to have a more comprehensive understanding of the clinical symptoms and prognosis of such disease.
. 2023 Nov 21.
doi: 10.1038/s41390-023-02904-8. Online ahead of print. Children with severe neurological symptoms associated with SARS-CoV-2 infection during Omicron pandemic in China
Tao Zhang[SUP] 1 [/SUP], Qiao-Feng Zhang[SUP] 2 [/SUP], Hong-Mei Yang[SUP] 2 [/SUP], Pin Liu[SUP] 3 [/SUP], Peng Sun[SUP] 3 [/SUP], Yu-Mei Li[SUP] 4 [/SUP], Zhen Zhang[SUP] 4 [/SUP], Yan-Zhi Huang[SUP] 5 [/SUP], Xin-Yan Yu[SUP] 6 [/SUP], Qi-Qi-Ge Chao-Lu-Men[SUP] 7 [/SUP], Qin Su[SUP] 7 [/SUP], Chun-Feng Liu[SUP] 8 [/SUP]
Affiliations
- PMID: 37990079
- DOI: 10.1038/s41390-023-02904-8
Background: To analyze the clinical characteristics and outcomes of children with severe neurological symptoms associated with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during the Omicron pandemic in China.
Methods: This study used a questionnaire to obtain data from pediatric intensive care unit (PICU) centers in seven tertiary hospitals in Northeast China from December 1, 2022, to January 31, 2023.
Results: A total of 255 patients were confirmed to have SARS-CoV-2 infection, and 45 patients (17.65 %) were included in this study. Of these, seven (15.6%) patients died, and the median time from admission to death was 35 h (IQR, 14-120 h). Twenty (52.6%) survivors experienced neurological sequelae. Patients with platelet counts lower than 100 × 10[SUP]9[/SUP]/L had a higher incidence of complications such as multiple organ dysfunction, mechanical ventilation rate, and mortality. Cranial magnetic resonance imaging (MRI) always reveals cerebral tissue edema, with some severe lesions forming a softening site.
Conclusion: Children infected with SARS-CoV-2 often exhibit severe neurological symptoms, and in some cases, they may rapidly develop malignant cerebral edema or herniation, leading to a fatal outcome. An early decrease in platelet count may associated with an unfavorable prognosis.
Impact: Since early December 2022, China has gradually adjusted its prevention and control policy of SARS-CoV-2; Omicron outbreaks have occurred in some areas for a relatively short period. Due to the differences in ethnicity, endemic strains and vaccination status, there was a little difference from what has been reported about children with SARS-CoV-2 infection with severe neurological symptoms in abroad. This is the first multicenter clinical study in children with nervous system involvement after acute SARS-CoV-2 infection in China, and helpful for pediatricians to have a more comprehensive understanding of the clinical symptoms and prognosis of such disease.