Neurodevelopment medium-term outcome after parechovirus infection

Valle, Fernando Martín del; Ruíz, Ana Menasalvas; Cilla, Amaia; González, Ana Velázquez; Vivas, María de Ceano; Sanz, María; Calvo, Cristina

doi:10.1016/j.earlhumdev.2019.03.005

Cited by 6 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12 Two smaller European studies also showed resolution of initial developmental concerns detected in the first 12 months of life by 24 months of life. 15,16 These findings are in contrast to a recent meta-analysis, which concluded rates of neurological sequelae increased over time (5% during short-term follow-up increasing to 27% during long-term follow-up). 8 This meta-analysis, however, defined 'long-term' follow-up as greater or equal to 12 months.…”

Section: Discussioncontrasting

confidence: 77%

“…This cohort demonstrated normal development on formal assessment at 3 years of age despite high rates of developmental concerns (50%) at 12–16 months of age 12 . Two smaller European studies also showed resolution of initial developmental concerns detected in the first 12 months of life by 24 months of life 15,16 . These findings are in contrast to a recent meta‐analysis, which concluded rates of neurological sequelae increased over time (5% during short‐term follow‐up increasing to 27% during long‐term follow‐up) 8 .…”

Section: Discussioncontrasting

confidence: 58%

See 1 more Smart Citation

Parechovirus infection in infants: Evidence‐based parental counselling for paediatricians

Silcock

Doyle

Clark

et al. 2021

J Paediatrics Child Health

View full text Add to dashboard Cite

Aim Human parechovirus (HPeV) is an increasingly recognised cause of severe illness and central nervous system infection in infants. Medium‐ to long‐term neurodevelopmental outcomes post‐HPeV infection remain unknown. This study aims to assess neurodevelopmental outcomes for children hospitalised as infants with HPeV infection in their second and third years of life. Methods This prospective cohort study followed children hospitalised with HPeV in Brisbane, Queensland during the 2017/2018 outbreak. Serial application of Ages and Stages Questionnaire (ASQ) was used to assess developmental progress in the second and third years of life. Data from clinical follow‐up, audiology and neuroradiology were included. Results In the second year of life, 63% (n = 29) of children showed some or significant concerns for developmental delay. This had largely been ameliorated by the third year of life when only 30% (n = 14) reported developmental concerns. Prematurity and apnoeas were associated with developmental concerns at 27–36 months of age. Communication was the most common domain of concern. Conclusions The majority of infants hospitalised with HPeV infection in 2017–2018 showed normalisation of developmental progress by 27–36 months of age. Further investigation into more subtle neurological impairments in later childhood is required. These results can help guide clinicians in counselling parents during the acute illness and in planning appropriate follow‐up.

show abstract

Section: Discussioncontrasting

confidence: 77%

Section: Discussioncontrasting

confidence: 58%

Parechovirus infection in infants: Evidence‐based parental counselling for paediatricians

Silcock

Doyle

Clark

et al. 2021

J Paediatrics Child Health

View full text Add to dashboard Cite

show abstract

“…Short-term outcomes are generally good, but medium and long-term outcomes of infants after PeV infections are still unknown. There are very few studies on the topic and those available are limited to small sample sizes with different methodologies (Martin Del Valle et al, 2019;Britton et al, 2016;Verboon-Maciolek et al, 2008). In general, the prognosis is more favourable when there is no CSF injury, whereas infants with encephalitis (alterations in neuroimaging and/or seizures) are more likely to develop neurological disability and white matter injury disease (Britton et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Human parechovirus type 5 neurological infection in a neonate with a favourable outcome: A case report

Piralla

Perniciaro

Ossola

et al. 2019

International Journal of Infectious Diseases

View full text Add to dashboard Cite

A B S T R A C TThe majority of parechovirus A type 5 (PeV-A5) infections have been reported in patients with gastrointestinal syndromes. In contrast, a sepsis-like illness associated with PeV-A5 infection has been reported only anecdotally. Herein, we report the first case in Italy of a PeV-A5 neurological infection presenting in a neonate with a sepsis-like syndrome. The patient, a healthy male infant born at 41 weeks of gestation, was highly distressed and inconsolable, and had been crying persistently, with poor breastfeeding, since the previous day. From day 2 to day 4, the newborn was feverish with mild irritability; breastfeeding was preserved and regularly supported. His clinical condition progressively improved, with defervescence on day 4. He was discharged after 7 days, and neurological examination results indicated only mild impairment in visual fixation and vertical eye tracking and mild axial hypotonia. The Italian PeV-A5 strain was phylogenetically related to three strains detected in Denmark in 2012, as well as to one detected in Australia and one in Greece in 2015, with an average nucleotide identity of 97.9% (range 95.9-100.0%). Enterovirus/PeV infection in the newborn should be ruled out in cases of infants with unexplained fever and/or a sepsis-like syndrome and/or meningoencephalitis. An aetiological diagnosis is essential to avoid the unnecessary administration of antibiotics and to plan longterm follow-up until schooling.

show abstract

“…Despite the methodological differences, the results were relatively similar to ours with a significant percentage of children with neurodevelopmental concern (27 and 20%, respectively). In a previous study from our group by Martin Del Valle et al, a satisfactory medium-term neurological development was observed in infants following HPeV infection, although mild alterations in gross and fine motor domains were present (19). The differences between study outcomes could be due to variations including the pathogenicity of HPeV, maternal immunity, age of developing infection or differences in host response to the virus (30).…”

Section: Discussionmentioning

confidence: 84%

“…Infants with HPeV infection without signs of encephalitis seem to have a better clinical outcome than those with a clear diagnosis of encephalitis. Martin del Valle et al observed a satisfactory medium-term neurological development in infants after HPeV infection ( 19 ). HPeV encephalitis is associated with neurodevelopmental sequelae despite the reassuring short-term outcomes of the infection ( 20 ).…”

Section: Introductionmentioning

confidence: 99%

Neurodevelopmental Outcomes of Infants Younger Than 90 Days Old Following Enterovirus and Parechovirus Infections of the Central Nervous System

et al. 2021

Self Cite

View full text Add to dashboard Cite

Enteroviruses (EVs) and human parechoviruses (HPeVs) are a major cause of central nervous system (CNS) infection in young infants. They have been implicated in neurodevelopmental delay, however limited data are available. The aim of this study is to describe the clinical outcome of young infants and to assess and compare the medium-term neurodevelopment following CNS infections caused by EV and HPeV. A multicentre observational ambispective study was conducted between May 2013 and March 2018. Children under 3 months of age with EV or HPeV CNS infection excluding encephalitis were included. Infants were contacted 1 year after the acute infection and their neurological development was evaluated using the Ages and Stages Questionnaire-3 (ASQ-3). If any area assessed was abnormal during the first round of tests, a second round was completed 6 to 12 months later. Forty-eight young infants with EV and HPeV CNS infection were identified: 33 (68.8%) were positive for EV and 15 (31.3%) for HPeV. At first assessment 14 out of 29 EV (48.3%) and 3 out of 15 HPeV (20%) positive cases presented some developmental concern in the ASQ-3 test. EV-positive infants showed mild and moderate alteration in all domains analyzed and HPeV-positive infants showed mild alterations only in gross and fine motor domains. Significant alterations in communication were observed in EV-positive but not in HPeV-positive infants (31 vs. 0%, p = 0.016). At second assessment 4 out of 13 EV-positive patients (30.8%) showed mild to moderate concerns in communication and gross motor function domains and 3 out of 13 (23.1%) showed significant concern in fine motor function. Although CNS infections without associated encephalitis are generally assumed to be benign our study shows that at a median age of 18 months almost half of the EV-infected infants (48.3%) and 20% of HPeV-positive infants presented some developmental concern in the ASQ-3 test. We recommend monitor the neurological development of infants during the first years of life after HPeV CNS infection and especially after EV CNS infection, even in mild cases, for an early intervention and stimulation of psychomotor development if necessary.

show abstract

Neurodevelopment medium-term outcome after parechovirus infection

Cited by 6 publications

References 23 publications

Parechovirus infection in infants: Evidence‐based parental counselling for paediatricians

Parechovirus infection in infants: Evidence‐based parental counselling for paediatricians

Human parechovirus type 5 neurological infection in a neonate with a favourable outcome: A case report

Neurodevelopmental Outcomes of Infants Younger Than 90 Days Old Following Enterovirus and Parechovirus Infections of the Central Nervous System

Contact Info

Product

Resources

About