Zhang Peipei, Xin Meiyun, Bai Yingge, Ren Xueyun, Li Na
Department of Pediatrics, Affiliated Hospital of Jining Medical University, Jining, 272007, Shandong, China.
Surrey College, Dongbei University of Finance and Economics, Dalian, 116025, Liaoning, China.
BMC Pediatr. 2025 Jan 27;25(1):63. doi: 10.1186/s12887-025-05436-8.
To investigate the clinical features and prognosis of severe central nervous system (CNS) injury in children caused by coronavirus disease 2019 (COVID-19).
We retrospectively studied confirmed pediatric cases of COVID-19 complicated with CNS injury.
Nine patients diagnosed with COVID-19 complicated with severe CNS injury were admitted to the pediatric intensive care unit of the Affiliated Hospital of Jining University from December 1, 2022 to January 12, 2023. Of the nine patients, seven were male (77.78%). Five children were aged ≥ 10 years, and the others were 1-2 years old. All children had fever, eight had convulsions, seven had progressed to multiple organ failure, and all suffered varying degrees of coma. Most of the children had elevated interleukin-6 (100%), lactic acid (100%), alanine transaminase (87.5%), aspartate transaminase (87.5%), creatine kinase MB (87.5%), and lactate dehydrogenase (85.7%) levels. Four children had cerebrospinal fluid proteinnacell separation. The cranial imaging results of five children were abnormal. One child had lost his vital signs when admitted to hospital, and the remaining eight received hormonal shock, human immunoglobulin transfusion, antinainfection, cranial pressure reduction, and tracheal intubation, among others, during hospitalization. Ultimately, eight children died, and the remaining child has serious neurological sequelae and is undergoing rehabilitation.
Severe CNS injury caused by COVID-19 has an acute onset, rapid progression, high disability rate, and high fatality rate. A low cerebrospinal fluid protein level may be a protective factor for children with severe nervous system injury caused by COVID-19.
探讨2019冠状病毒病（COVID-19）所致儿童重症中枢神经系统（CNS）损伤的临床特征及预后。
我们回顾性研究确诊的COVID-19合并CNS损伤的儿科病例。
2022年12月1日至2023年1月12日，9例诊断为COVID-19合并重症CNS损伤的患儿入住济宁医学院附属医院儿科重症监护病房。9例患儿中，7例为男性（77.78%）。5名儿童年龄≥10岁，其他儿童为1-2岁。所有儿童均有发热，8例有惊厥，7例进展为多器官功能衰竭，均有不同程度昏迷。大多数儿童白细胞介素-6（100%）、乳酸（100%）、谷丙转氨酶（87.5%）、谷草转氨酶（87.5%）、肌酸激酶同工酶（87.5%）和乳酸脱氢酶（85.7%）水平升高。4例儿童脑脊液蛋白细胞分离。5例儿童头颅影像学检查结果异常。1例患儿入院时已无生命体征，其余8例患儿住院期间接受了激素冲击、输注人免疫球蛋白、抗感染、降颅压及气管插管等治疗。最终，8例患儿死亡，其余1例患儿有严重神经后遗症，正在接受康复治疗。
COVID-19所致重症CNS损伤起病急、进展快、致残率高、病死率高。脑脊液蛋白水平低可能是COVID-19所致重症神经系统损伤患儿的保护因素。
