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https://observatorio.fm.usp.br/handle/OPI/46027
Title: | Prevalence and Risk Factors of Neurologic Manifestations in Hospitalized Children Diagnosed with Acute SARS-CoV-2 or MIS-C |
Authors: | FINK, Ericka L.; ROBERTSON, Courtney L.; WAINWRIGHT, Mark S.; ROA, Juan D.; LOVETT, Marlina E.; STULCE, Casey; YACOUB, Mais; POTERA, Renee M.; ZIVICK, Elizabeth; HOLLOWAY, Adrian; NAGPAL, Ashish; WELLNITZ, Kari; CZECH, Theresa; EVEN, Katelyn M.; CARVALHO, Werther Brunow de; RODRIGUEZ, Isadora Souza; SCHWARTZ, Stephanie P.; WALKER, Tracie C.; CAMPOS-MINO, Santiago; DERVAN, Leslie A.; GENESLAW, Andrew S.; SEWELL, Taylor B.; PRYCE, Patrice; SILVER, Wendy G.; LIN, Jieru Egeria; VARGAS, Wendy S.; TOPJIAN, Alexis; ALCAMO, Alicia M.; MCGUIRE, Jennifer L.; ROJAS, Jesus Angel Dominguez; MUNOZ, Jaime Tasayco; HONG, Sue J.; MULLER, William J.; DOERFLER, Matthew; WILLIAMS, Cydni N.; DRURY, Kurt; BHAGAT, Dhristie; NELSON, Aaron; PRICE, Dana; DAPUL, Heda; SANTOS, Laura; KAHOUD, Robert; FRANCOEUR, Conall; APPAVU, Brian; GUILLIAMS, Kristin P.; AGNER, Shannon C.; WALSON, Karen H.; RASMUSSEN, Lindsey; JANAS, Anna; FERRAZZANO, Peter; FARIAS-MOELLER, Raquel; SNOOKS, Kellie C.; CHANG, Chung-Chou H.; YUN, James; SCHOBER, Michelle E. |
Citation: | PEDIATRIC NEUROLOGY, v.128, p.33-44, 2022 |
Abstract: | Background: Our objective was to characterize the frequency, early impact, and risk factors for neuro-logical manifestations in hospitalized children with acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or multisystem inflammatory syndrome in children (MIS-C). Methods: Multicenter, cross-sectional study of neurological manifestations in children aged <18 years hospitalized with positive SARS-CoV-2 test or clinical diagnosis of a SARS-CoV-2-related condition be-tween January 2020 and April 2021. Multivariable logistic regression to identify risk factors for neuro-logical manifestations was performed. Results: Of 1493 children, 1278 (86%) were diagnosed with acute SARS-CoV-2 and 215 (14%) with MIS-C. Overall, 44% of the cohort (40% acute SARS-CoV-2 and 66% MIS-C) had at least one neurological mani-festation. The most common neurological findings in children with acute SARS-CoV-2 and MIS-C diag-nosis were headache (16% and 47%) and acute encephalopathy (15% and 22%), both P < 0.05. Children with neurological manifestations were more likely to require intensive care unit (ICU) care (51% vs 22%), P < 0.001. In multivariable logistic regression, children with neurological manifestations were older (odds ratio [OR] 1.1 and 95% confidence interval [CI] 1.07 to 1.13) and more likely to have MIS-C versus acute SARS-CoV-2 (OR 2.16, 95% CI 1.45 to 3.24), pre-existing neurological and metabolic conditions (OR 3.48, 95% CI 2.37 to 5.15; and OR 1.65, 95% CI 1.04 to 2.66, respectively), and pharyngeal (OR 1.74, 95% CI 1.16 to 2.64) or abdominal pain (OR 1.43, 95% CI 1.03 to 2.00); all P < 0.05. Conclusions: In this multicenter study, 44% of children hospitalized with SARS-CoV-2-related conditions experienced neurological manifestations, which were associated with ICU admission and pre-existing neurological condition. Posthospital assessment for, and support of, functional impairment and neuro-protective strategies are vitally needed. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - COVID-19 Artigos e Materiais de Revistas Científicas - FM/MPE Artigos e Materiais de Revistas Científicas - LIM/36 Artigos e Materiais de Revistas Científicas - ODS/03 |
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