Prevalence and Risk Factors of Neurologic Manifestations in Hospitalized Children Diagnosed with Acute SARS-CoV-2 or MIS-C.
Prevalence and Risk Factors of Neurologic Manifestations in Hospitalized Children Diagnosed with Acute SARS-CoV-2 or MIS-C.
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DOI：
10.1016/j.pediatrneurol.2021.12.010
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发表时间：
2022-03
影响因子：
3.8
通讯作者：
Global Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID) Investigators
中科院分区：
文献类型：
--
作者：
Fink EL;Robertson CL;Wainwright MS;Roa JD;Lovett ME;Stulce C;Yacoub M;Potera RM;Zivick E;Holloway A;Nagpal A;Wellnitz K;Czech T;Even KM;Brunow de Carvalho W;Rodriguez IS;Schwartz SP;Walker TC;Campos-Miño S;Dervan LA;Geneslaw AS;Sewell TB;Pryce P;Silver WG;Lin JE;Vargas WS;Topjian A;Alcamo AM;McGuire JL;Domínguez Rojas JA;Muñoz JT;Hong SJ;Muller WJ;Doerfler M;Williams CN;Drury K;Bhagat D;Nelson A;Price D;Dapul H;Santos L;Kahoud R;Francoeur C;Appavu B;Guilliams KP;Agner SC;Walson KH;Rasmussen L;Janas A;Ferrazzano P;Farias-Moeller R;Snooks KC;Chang CH;Yun J;Schober ME;Global Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID) Investigators
我们的目的是描述急性严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)感染或儿童多系统炎症综合征(MIS-C)住院儿童的神经系统表现的频率、早期影响和危险因素。对2020年1月至2021年4月期间因SARS-CoV-2检测阳性或临床诊断为SARS-CoV-2相关疾病而住院的18岁儿童的神经系统表现进行多中心横断面研究。采用多变量Logistic回归分析神经表现的危险因素。在1493名儿童中，1278名(86%)被诊断为急性SARS-CoV-2,215名(14%)被诊断为MIS-C。总体而言，44%的队列(40%的急性SARS-CoV-2和66%的MIS-C)至少有一种神经表现。在急性SARS-CoV-2和MISC诊断的儿童中，最常见的神经学表现是头痛(16%和47%)和急性脑病(15%和22%)，P均<0.05。有神经系统症状的儿童更有可能需要重症监护病房的护理(51%比22%)，P<；0.001。在多变量Logistic回归分析中，有神经系统症状的儿童年龄较大(优势比[OR]1.1和95%可信区间[CI]1.07~1.13)，且更有可能患有MISC与急性SARS-CoV-2(OR 2.16，95%CI 1.45~3.24)，既往神经系统和代谢疾病(OR 3.48，95%CI 2.37~5.15；与OR 1.65，95%CI分别为1.04~2.66)、咽部(OR 1.74，95%CI为1.16~2.64)或腹痛(OR 1.43，95%CI为1.03~2.00)；均P<0.05。在这项多中心研究中，44%的患有SARS-CoV-2相关疾病的住院儿童出现了神经系统症状，这些症状与ICU入院和先前存在的神经状况有关。术后对功能损害和神经保护策略的评估和支持是至关重要的。
Our objective was to characterize the frequency, early impact, and risk factors for neurological manifestations in hospitalized children with acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or multisystem inflammatory syndrome in children (MIS-C). 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 between January 2020 and April 2021. Multivariable logistic regression to identify risk factors for neurological manifestations was performed. 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 manifestation. The most common neurological findings in children with acute SARS-CoV-2 and MIS-C diagnosis 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. 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 neuroprotective strategies are vitally needed.
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影响因子：
5.1
作者：
Frankl, Sarah;Coffin, Susan E.;McGuire, Jennifer L.
通讯作者：
McGuire, Jennifer L.
影响因子：
11.2
作者：
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影响因子：
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作者：
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通讯作者：
Reeder, Ron W.
影响因子：
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作者：
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