Neurological Complications in Children Hospitalized With Seizures and Respiratory Infections: A Comparison Between SARS-CoV-2 and Other Respiratory Infections

Gombolay, Grace; Xiang, Yijin; Bai, Shasha; Rostad, Christina A.; Tyor, William R.

doi:10.1016/j.pediatrneurol.2022.07.010

Cited by 6 publications

(4 citation statements)

References 15 publications

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“…About clinical presentation, our findings are in line with HAdV being a common cause of upper and lower RTI in children, estimated to cause 2-5% of pediatric respiratory tract infections and 4-10% of all pediatric cases of pneumonia [12]. However, our paper further confirmed that HAdV is also a common cause of febrile seizures, since in a large previous report it was described as a rare complication [5], but commoner in others [13][14][15].…”

Section: Discussionsupporting

confidence: 87%

Determinants of antibiotic prescription in children with adenovirus respiratory tract infections

Buonsenso,

Camporesi,

Viozzi

et al. 2024

Eur J Pediatr

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We performed this study to evaluate factors associated with antibiotic prescriptions in children with adenovirus infection, since no studies have attempted to address this aspect in the pediatric population. Retrospective study of children younger than 18 years of age tested positive for adenovirus on a syndromic nasopharyngeal test from 2018 to 2023. We compared the need of pediatric intensive care unit (PICU), invasive ventilation, and other respiratory support, viral etiologies, clinical presentations, imaging, and laboratory results in the precovid (2018–2019) and covid (2020–2022) period. The use of antibiotics was studied with multivariable logistic regression including demographic as well as clinical data as covariates. Two hundred fifty-eight patients were enrolled. One hundred fifty-eight patients received an antibiotic (mean duration 6.2 (±2.7) days (median 4; IQR: 4–7)). Presence of seizures and C-reactive protein values as predictors for antibiotic prescription (OR for seizures: 12.17; 95% CI: 1.42–103.91; p = 0.022; OR for CrP: 1.03; 95% CI: 1.01–1.04; p = 0.001). Seventy-four patients received intravenous antibiotics (74/156, 47.4%). Risk factors for intravenous antibiotic were the presence of decay (OR: 3.74; 95% CI: 1.25–11.71; p = 0.018), CrP values (OR: 1.02; 95% CI: 1.00–1.03; p = 0.001), and presence of seizures (OR: 16.34; 95% CI: 2.65–100.83; p = 0.003). Duration of intravenous antibiotics correlated with the presence of seizures (Coeff: 1.6; 95% CI: 0.41–2.89; p = 0.009) even when adjusted for CrP values. Conclusion: The clinical presentation of adenovirus infection in children is non-specific, leading to frequent antibiotic prescription despite bacterial co-infections was rare. Higher CrP values and presenting with seizures are significantly associated with a higher risk of receiving antibiotics. Rapid microbiological tests and newer biomarkers can help clinicians to improve antibiotic prescription in this cohort of children. What is Known:•Adenovirus infection is a common cause of fever and respiratory tract infections in children.•Children with adenovirus infections frequently receive antibiotics, but determinants of this practice are poorly established. What is New:• Higher C-reactive protein values and presenting with seizures are significantly associated with antibiotic prescription. • Since the beginning of COVID-19 and implementation of rapid diagnostics, less children with adenovirus infection received antibiotics.

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Section: Discussionsupporting

confidence: 87%

Determinants of antibiotic prescription in children with adenovirus respiratory tract infections

Buonsenso,

Camporesi,

Viozzi

et al. 2024

Eur J Pediatr

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“…Although the liver and kidney function in the MP group remained within the normal limits, their measured values were significantly higher than those of the non-MP group, suggesting that MP infection can induce substantial extrapulmonary damage ( 14 , 24 , 25 ). Moreover, our results demonstrated that the MP infection induced higher incidence of neurological system complications, which indicated that the inflammation responses for MP would potentially contribute to neurological injuries ( 26 , 27 ). The pathogenesis of MP-induced extrapulmonary manifestations typically involves three possible mechanisms: direct damage resulting from invasion or locally produced inflammatory cytokines, indirect damage mediated by the immune system, and vascular occlusion due to vasculitis or thrombosis ( 28 , 29 ).…”

Section: Discussionmentioning

confidence: 62%

Mycoplasma infection aggravates cardiac involvements in Kawasaki diseases: a retrospective study

Lu,

Li,

Tang

et al. 2024

Front. Immunol.

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BackgroundMycoplasma pneumoniae (MP) infection serves as a substantial cofactor in Kawasaki disease (KD) among patients. Although the dominant issue triggering KD has recently focused on MP infection, the complete demonstration of the relationship between MP infection and KD remains elusive. This study endeavors to scrutinize and compare the clinical manifestations and cardiac involvement between MP-triggered KD and non-infection–associated KD.MethodThis retrospective study (2023-039, approved by the Institutional Review Board of West China Second University Hospital of Sichuan University) encompassed 247 consecutive patients diagnosed with KD between June 2017 and December 2022. Patients were categorized into two groups: the MP group (n = 38) and the non-MP group (n = 209). Univariable analysis was utilized to discern differences in clinical features, severity of inflammation, and initial or persistent cardiac complications between the two groups.ResultsThe MP group exhibited a more intricate clinical profile compared with the non-MP group, characterized by prolonged hospital stays, a higher incidence of incomplete KD, and elevated comorbidities. In addition, MP infection correlated with severe hematological disorders, coagulation dysfunction, and myocardial injuries. Our findings revealed that MP infection led to prolonged inflammation after initial treatment with intravenous immunoglobulin. Although initial cardiac assessments failed to discern disparities between the two groups, MP infection notably exacerbated coronary artery aneurysms (CAAs), resulting in sustained dilation.ConclusionsRecognizing MP infection as a significant infectious factor associated with KD is imperative. In patients with KD, MP infection significantly prolongs inflammation and causes hematological disturbances during the initial treatment phase. Moreover, the presence of MP infection exacerbates the progression of CAAs and myocardial injuries during the subacute phase of KD, consequently contributing to the persistence of CAAs.

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“…Risk for ADS is rare in SARS-CoV-2 infection, as 8/1695 (0.5%) children hospitalized for acute SARS-CoV-2 infection developed either infectious encephalitis or ADEM [2] . Moreover, we performed a study on rates of neurological comorbid diagnoses in 883 children hospitalized for seizures and respiratory infections, including SARS-CoV-2, influenza, parainfluenza, and mycoplasma, and none of these children had ADS [47] . Whether SARS-CoV-2 infection worsens or triggers relapses in demyelinating diseases in children are also unclear given the limited studies available.…”

Section: Discussion and Conclusion: Knowledge Gapsmentioning

confidence: 99%

COVID-19 and the Pandemic-Related Aspects in Pediatric Demyelinating Disorders

Gombolay

Hallman-Cooper

2023

Seminars in Pediatric Neurology

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Neurological Complications in Children Hospitalized With Seizures and Respiratory Infections: A Comparison Between SARS-CoV-2 and Other Respiratory Infections

Cited by 6 publications

References 15 publications

Determinants of antibiotic prescription in children with adenovirus respiratory tract infections

Determinants of antibiotic prescription in children with adenovirus respiratory tract infections

Mycoplasma infection aggravates cardiac involvements in Kawasaki diseases: a retrospective study

COVID-19 and the Pandemic-Related Aspects in Pediatric Demyelinating Disorders

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