Department of Infectious Diseases & Pediatric Intensive Care Unit, Children's Hospital of Soochow University, 303 Jingde Road, Suzhou, 215000, Jiangsu, China.
BMC Infect Dis. 2023 Dec 6;23(1):856. doi: 10.1186/s12879-023-08556-7.
The neurological symptoms caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are of increasing concern. Convulsions are among the main neurological manifestations reported in children with coronavirus disease-2019 (COVID-19), and cause serious harm to physical and mental health. This study aimed to investigate the risk factors for convulsion in children with COVID-19.
This prospective study was conducted at the Children's Hospital of Soochow University. In total, 102 COVID-19 patients with convulsion, 172 COVID-19 patients without convulsion, and 50 healthy controls were enrolled in the study. The children's clinical and laboratory data were analyzed to assess the risk factors for convulsion in COVID-19 patients.
Convulsions occurred in 37.2% of children, mostly those aged 1-3 years, who were hospitalized with the Omicron variant. The neutrophil count, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume-to-platelet ratio (MPR) were significantly higher in the convulsion group than those in the non-convulsion and control groups (P < 0.01). However, the counts of lymphocytes, eosinophils, platelets, lymphocyte subsets, CD3 T cells, CD4 T cells, CD8 T cells, and NK cells were lower in the convulsion group than those in the non-convulsion and control groups (P < 0.01). Multivariate regression analysis indicated that NK cell count (OR = 0.081, 95% CI: 0.010-0.652) and a history of febrile seizure (OR = 10.359, 95% CI: 2.115-50.746) were independent risk factors for the appearance of convulsions in COVID-19.
History of febrile seizure and decreased NK cell count were high-risk factors for convulsions in COVID-19 patients.
严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起的神经系统症状引起了越来越多的关注。抽搐是儿童 2019 年冠状病毒病（COVID-19）的主要神经系统表现之一，对身心健康造成严重危害。本研究旨在探讨 COVID-19 患儿抽搐的危险因素。
这是一项在苏州大学儿童医院进行的前瞻性研究。共纳入 102 例 COVID-19 伴抽搐患儿、172 例 COVID-19 无抽搐患儿和 50 例健康对照。分析患儿的临床和实验室资料，评估 COVID-19 患儿抽搐的危险因素。
抽搐发生率为 37.2%，主要发生在 1-3 岁，感染奥密克戎变异株，住院的患儿。抽搐组的中性粒细胞计数、中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）、血小板与淋巴细胞比值（PLR）和平均血小板体积与血小板比值（MPR）明显高于无抽搐组和对照组（P < 0.01）。然而，抽搐组的淋巴细胞、嗜酸性粒细胞、血小板、淋巴细胞亚群、CD3 T 细胞、CD4 T 细胞、CD8 T 细胞和 NK 细胞计数明显低于无抽搐组和对照组（P < 0.01）。多变量回归分析表明，NK 细胞计数（OR = 0.081，95%CI：0.010-0.652）和热性惊厥史（OR = 10.359，95%CI：2.115-50.746）是 COVID-19 患儿抽搐发生的独立危险因素。
热性惊厥史和 NK 细胞计数降低是 COVID-19 患儿抽搐的高危因素。
