Rise of Neurologic Manifestations During SARS-CoV-2 Omicron Wave in Children With COVID-19

Dimopoulou, Dimitra; Dasoula, Foteini; Liaska, Marianthi; Eleftheriou, Irini; Maritsi, Despoina; Τσολιά, Μαρία; Vartzelis, George

doi:10.1097/inf.0000000000003826

Cited by 8 publications

(6 citation statements)

References 6 publications

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“…Studies that analyzed the neurological manifestations during the Omicron wave and compared them with previous periods or other SARS-CoV-2 variants found evidence to support the increase in neurological symptoms [ 66 , 71 , 72 , 73 ]. In contrast, Antoon et al [ 64 ] noted more neurological manifestations during the Wuhan wave than during the Omicron wave.…”

Section: Discussionmentioning

confidence: 99%

Neurological Manifestations of Acute SARS-CoV-2 Infection in Pediatric Patients: A 3-Year Study on Differences between Pandemic Waves

Vivisenco,

Lescaie,

Dragomirescu

et al. 2024

Viruses

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This study analyzed the neurological manifestation profiles of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across pandemic waves in pediatric patients. The study collected data on patients aged between 0 and 18 years, diagnosed with acute SARS-CoV-2 infection, admitted to a pediatric tertiary hospital between 1 March 2020 and 28 February 2023. This study included 1677 patients. Neurological manifestations were noted in 10% (n = 168) of patients with a median age of 3.2 years (interquartile range: 1–11.92). Neurological manifestations were significantly associated with the pandemic waves (p = 0.006) and age groups (p < 0.001). Seizures were noted in 4.2% of cases and reached an increasing frequency over time (p = 0.001), but were not associated with age groups. Febrile seizures accounted for the majority of seizures. Headache was reported in 2.6% of cases and had similar frequencies across the pandemic waves and age groups. Muscular involvement was noted in 2% of cases, reached a decreasing frequency over time (p < 0.001), and showed different frequencies among the age groups. Neurological manifestations of acute SARS-CoV-2 infection exhibit distinct patterns, depending on the pandemic wave and patient age group. The Wuhan and Omicron waves involved the nervous system more often than the other waves.

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Section: Discussionmentioning

confidence: 99%

Neurological Manifestations of Acute SARS-CoV-2 Infection in Pediatric Patients: A 3-Year Study on Differences between Pandemic Waves

Vivisenco,

Lescaie,

Dragomirescu

et al. 2024

Viruses

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“…22 Several reports have reported increased seizures during the Omicron surge compared to previous variants. [23][24][25] A multicenter observational study in the first wave of Omicron in South Africa revealed that 19 out of 61 (31%) children hospitalized for COVID-19 experienced seizures, highlighting that seizures may be a frequent symptom of this variant. According to this study, most patients presented with simple febrile seizures.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, before the Omicron variant's emergence, a few studies described seizures in pediatric patients 22 . Several reports have reported increased seizures during the Omicron surge compared to previous variants 23–25 . A multicenter observational study in the first wave of Omicron in South Africa revealed that 19 out of 61 (31%) children hospitalized for COVID‐19 experienced seizures, highlighting that seizures may be a frequent symptom of this variant.…”

Section: Discussionmentioning

confidence: 99%

The diversity in the clinical features of children hospitalized with COVID‐19 during the nonvariant, Alpha (B.1.1.7), Delta (B.1.617.2), and Omicron (B.1.1.529) variant periods of SARS CoV‐2: Caution for neurological symptoms in Omicron variant

Şahin

Karadağ‐Öncel

Buyuksen

et al. 2023

Journal of Medical Virology

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Since the COVID-19 pandemic began, various severe acute respiratory syndrome coronavirus 2 variants have been identified with different characteristics than the nonvariant strain. We retrospectively evaluated the demographic and clinical differences in the cohort of hospitalized COVID-19 children (1 month-18 years old) between March 11, 2020, and September 31, 2022, by the time the variants identified in our country predominate. Bonferroni post hoc analysis was performed to compare the differences between the periods. Of the 283 children in this study, 142 (50.2%) were females. The median age was 36 (interquartile range [IQR]: 7-132) months. Sixty-three (22.2%) patients were hospitalized in the nonvariant period, 24 (8.5%) in the Alpha period, 93 (32.9%) in the Delta period, and 103 (36.4%) in the Omicron period. Fever was the most common symptom in all groups, with no statistically significant differences (p = 0.25). In the Omicron period, respiratory and gastrointestinal symptoms decreased, and neurological symptoms increased significantly compared to other periods: [respiratory symptoms; nonvariant (65.1%) vs. Omicron (41.7%), (p = 0.024)], [gastrointestinal symptoms; Delta (41.9%) vs. Omicron (22.3%), (p = 0.018), [neurological symptoms; Delta (14.5%) vs. Omicron (31.1%), (p = 0.03]. Altered mental status and seizures were more common during the Omicron period compared to the pre-Omicron (nonvariant, Alpha, and Delta) period (p = 0.017 and p = 0.005, respectively). Although the main symptoms in children with COVID-19 were fever and respiratory symptoms, an increase in severe neurological manifestations was seen throughout the Omicron variant period.

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“…Park et al cited an interesting finding, showing that despite shifts in the patterns of respiratory viral infections, the clinical features and outcomes of febrile seizures remained consistent before and throughout the COVID-19 pandemic [ 46 ]. Moreover, Dimopoulou et al identified 44.8% of patients having febrile seizures during the SARS-CoV-2 Omicron wave [ 47 ]. This study highlighted that while SARS-CoV-2 can be a triggering factor, other pre-existing conditions or viruses play a synergistic role in the development and presentation of the febrile seizure and raises pertinent questions about the diverse clinical presentations across pediatric populations and the possible geographical or cohort-specific variations that exist.…”

Section: Discussionmentioning

confidence: 99%

Impact of Respiratory Viruses and SARS-CoV-2 on Febrile Seizures in Saudi Children: Insights into Etiologies, Gender, and Familial Associations

AlFulayyih,

Al Baridi,

Alomar

et al. 2023

Med Sci Monit

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Background Childhood febrile seizures occur between 5 months and 6 years of age in children without a previous history of seizure and are associated with high temperature in the absence of intracranial infection. This retrospective study identified 71 children aged 6 months to 5 years with febrile seizures between 2017 and 2021 at a single center in Saudi Arabia and aimed to identify an association between common respiratory virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Material/Methods Pediatric nasopharyngeal specimens were tested using a multiplex PCR respiratory panel detecting human coronaviruses (NL63, 229E, OC43, HKU1), influenza A/B, human adenovirus, parainfluenza viruses 1–4, respiratory syncytial virus, human metapneumovirus, rhinovirus/enterovirus, Middle East respiratory syndrome coronavirus, and, as of September 2021, SARS-CoV-2, confirmed using the Cepheid Xpert Xpress SARS-CoV2 RT-PCR kit. Results In a cohort of 71 pediatric patients (median age, 19 months; 54.9% female), dominant pathogens included human rhinovirus/enterovirus (23.9%), influenza A/B (26.8%), and SARS-CoV-2 (14.1%). Concurrent infections were noted in 28.2%. Simple seizures occurred in 69%, and complex seizures in 31%. Females exhibited an 8.18-fold increased risk for complex seizures. Each additional fever day reduced complex seizure risk by 36%. Familial seizure history increased risk 8.76-fold. Human rhinovirus/enterovirus or parainfluenza infections inversely affected complex seizure likelihood compared with adenovirus. Conclusions In Saudi children with febrile seizures, distinct viral etiologies, sex, and familial links play pivotal roles. Given regional viral variations, region-tailored diagnostic and therapeutic strategies are paramount. A multicenter prospective cohort study is essential for comprehensive understanding.

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Rise of Neurologic Manifestations During SARS-CoV-2 Omicron Wave in Children With COVID-19

Abstract: ICU indicates intensive care unit. Bold indicates statistically significant value.

Cited by 8 publications

References 6 publications

Neurological Manifestations of Acute SARS-CoV-2 Infection in Pediatric Patients: A 3-Year Study on Differences between Pandemic Waves

Neurological Manifestations of Acute SARS-CoV-2 Infection in Pediatric Patients: A 3-Year Study on Differences between Pandemic Waves

The diversity in the clinical features of children hospitalized with COVID‐19 during the nonvariant, Alpha (B.1.1.7), Delta (B.1.617.2), and Omicron (B.1.1.529) variant periods of SARS CoV‐2: Caution for neurological symptoms in Omicron variant

Impact of Respiratory Viruses and SARS-CoV-2 on Febrile Seizures in Saudi Children: Insights into Etiologies, Gender, and Familial Associations

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