Division of Neurology, Department of Pediatrics, Emory University School of Medicine, Atlanta Georgia; Division of Pediatric Neurology, Children's Healthcare of Atlanta, Atlanta Georgia.
Department of Neurology, Emory University School of Medicine, Atlanta, Georgia.
Pediatr Neurol. 2022 Oct;135:52-55. doi: 10.1016/j.pediatrneurol.2022.07.010. Epub 2022 Jul 30.
Children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can experience neurological symptoms, but limited data are available on neurological symptoms associated with other respiratory infections. We compared proportions of neurological symptoms in children hospitalized with seizures and respiratory infections, including SARS-CoV-2, influenza, and endemic coronaviruses.
A retrospective cohort study was performed on children admitted for seizures who had positive respiratory polymerase chain reactions for SARS-CoV-2, coronavirus NL63, coronavirus OC34, influenza (A and B), adenovirus, Mycoplasma pneumoniae, or parainfluenza 3 or 4. Primary outcomes were rates of new neurological diagnoses and mortality.
A total of 883 children were included. Mortality rates ranged from 0% with M. pneumoniae to 4.9% with parainfluenza 4. Strokes were observed with all infections except for coronavirus OC43 and M. pneumoniae, with the highest rates in parainfluenza 4 (4.9%) and SARS-CoV-2 (5.9%). Compared with other infections, children with SARS-CoV-2 were older, had higher rates of stroke, and lower rates of intubation. The most common brain magnetic resonance imaging (MRI) abnormality was diffusion restriction. Abnormal MRI rates were lower in SARS-CoV-2, compared with patients with other coronavirus (OC). However, rates of stroke, encephalopathy, hypoxic-ischemic encephalopathy, and meningoencephalitis were similar between SARS-CoV-2 and influenza cohorts.
In children hospitalized with seizures, higher rates of stroke were observed in SARS-CoV-2 versus OC. Similar rates of neurological symptoms were observed in patients with SARS-CoV-2 and those with influenza. Strokes can occur in children with these viral infections, particularly SARS-CoV-2.
患有严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染的儿童可能会出现神经系统症状，但有关其他呼吸道感染相关神经系统症状的资料有限。我们比较了因癫痫发作而住院的儿童中伴有神经系统症状的比例，这些感染包括 SARS-CoV-2、流感和地方性冠状病毒。
对因 SARS-CoV-2、冠状病毒 NL63、冠状病毒 OC34、流感（A 和 B）、腺病毒、肺炎支原体或副流感 3 或 4 型呼吸道聚合酶链反应阳性而住院的癫痫发作患儿进行回顾性队列研究。主要结局是新发神经系统诊断和死亡率。
共纳入 883 例患儿。死亡率范围为 0%（肺炎支原体）至 4.9%（副流感 4 型）。除冠状病毒 OC43 和肺炎支原体外，所有感染均可见到脑卒中，副流感 4 型（4.9%）和 SARS-CoV-2（5.9%）的发生率最高。与其他感染相比，SARS-CoV-2 患儿年龄较大，脑卒中发生率较高，插管率较低。最常见的脑磁共振成像（MRI）异常是弥散受限。与其他冠状病毒（OC）患儿相比，SARS-CoV-2 患儿 MRI 异常率较低。然而，SARS-CoV-2 组与流感组的脑卒中、脑病、缺氧缺血性脑病和脑膜脑炎发生率相似。
在因癫痫发作而住院的儿童中，SARS-CoV-2 患儿脑卒中的发生率高于 OC 患儿。SARS-CoV-2 患儿和流感患儿的神经系统症状发生率相似。这些病毒感染可导致儿童发生脑卒中，尤其是 SARS-CoV-2。
