Severe encephalopathy associated with SARS-CoV-2 Omicron BA.1 variant infection in a neonate

Tetsuhara, Kenichi; Akamine, Satoshi; Matsubara, Yoshie; Fujii, Shunsuke; Kashimada, Wataru; Marutani, Kentaro; Torio, Michiko; Morooka, Yuya; Hanaoka, Nozomu; Fujimoto, Tsuguto; Nakamura-Miwa, Haruna; Arai, Satoru; Tanaka‐Taya, Keiko; Furuno, Kenji; Mizuno, Yumi; Kira, Ryutaro

doi:10.1016/j.braindev.2022.06.010

Cited by 19 publications

(21 citation statements)

References 19 publications

(20 reference statements)

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“…However, the severity of SARS-CoV-2 variants is multifaceted because of varying levels of individual immune status, which calls for caution against underestimating the pathogenicity induced by the Omicron variant. Recently, severe encephalopathy associated with the Omicron BA.1 variant was reported in a neonate [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 Omicron variant causes brain infection with lymphoid depletion in a mouse COVID-19 model

Lee

Hong

et al. 2023

Lab Anim Res

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Background The Omicron variant has become the most prevalent SARS-CoV-2 variant. Omicron is known to induce milder lesions compared to the original Wuhan strain. Fatal infection of the Wuhan strain into the brain has been well documented in COVID-19 mouse models and human COVID-19 cases, but apparent infections into the brain by Omicron have not been reported in human adult cases or animal models. In this study, we investigated whether Omicron could spread to the brain using K18-hACE2 mice susceptible to SARS-CoV-2 infection. Results K18-hACE2 mice were intranasally infected with 1 × 105 PFU of the original Wuhan strain and the Omicron variant of SARS-CoV-2. A follow-up was conducted 7 days post infection. All Wuhan-infected mice showed > 20% body weight loss, defined as the lethal condition, whereas two out of five Omicron-infected mice (40%) lost > 20% body weight. Histopathological analysis based on H&E staining revealed inflammatory responses in the brains of these two Omicron-infected mice. Immunostaining analysis of viral nucleocapsid protein revealed severe infection of neuron cells in the brains of these two Omicron-infected mice. Lymphoid depletion and apoptosis were observed in the spleen of Omicron-infected mice with brain infection. Conclusion Lethal conditions, such as severe body weight loss and encephalopathy, can occur in Omicron-infected K18-hACE2 mice. Our study reports, for the first time, that Omicron can induce brain infection with lymphoid depletion in the mouse COVID-19 model.

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Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 Omicron variant causes brain infection with lymphoid depletion in a mouse COVID-19 model

Lee

Hong

et al. 2023

Lab Anim Res

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“…A total of 11 publications describing 46 pediatric patients with COVID‐19–related neurological manifestations were included in the systematic review 17,31–40 (Table 4). Among the 46 patients, 19 (41.3%) were female and 27 (58.7%) were males.…”

Section: Resultsmentioning

confidence: 99%

Clinical characteristics of unvaccinated or incompletely vaccinated children with neurological manifestations due to SARS‐CoV‐2 Omicron infection

Tso

Kwan²,

Kwok

et al. 2023

Journal of Medical Virology

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Omicron generally causes milder disease than previous strains of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), especially in fully vaccinated individuals. However, incompletely vaccinated children may develop Omicronrelated complications such as those affecting the central nervous system. To characterize the spectrum of clinical manifestations of neuro-COVID and to identify potential biomarkers associated with clinical outcomes, we recruited 15 children hospitalized for Omicron-related neurological manifestations in three hospitals in Hong Kong (9 boys and 6 girls aged 1-13 years). All were unvaccinated or incompletely vaccinated. Fourteen (93.3%) were admitted for convulsion, including

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“…In addition, patients without a history of epilepsy presented with status epilepticus have been reported due to Omicron subvariant BA.1 infection in Japan 30 . Apart from convulsion, a patient with severe encephalopathy associated with COVID‐19 in the neonatal and early infancy periods due to Omicron BA.1 subvariant has been identified 31 . Recently, five cases of Omicron BA.2.3.7 subvariant infection with severe neurological symptoms were also identified in Taiwan 32 …”

Section: Discussionmentioning

confidence: 99%

“…30 Apart from convulsion, a patient with severe encephalopathy associated with COVID-19 in the neonatal and early infancy periods due to Omicron BA.1 subvariant has been identified. 31 Recently, five cases of Omicron BA.2.3.7 subvariant infection with severe neurological symptoms were also identified in Taiwan. 32 As a result of our study, the clinical progression scale, need for oxygen support, and PICU admission were not different according to SARS-CoV-2 periods in children hospitalized with COVID-19.…”

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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Severe encephalopathy associated with SARS-CoV-2 Omicron BA.1 variant infection in a neonate

Cited by 19 publications

References 19 publications

SARS-CoV-2 Omicron variant causes brain infection with lymphoid depletion in a mouse COVID-19 model

SARS-CoV-2 Omicron variant causes brain infection with lymphoid depletion in a mouse COVID-19 model

Clinical characteristics of unvaccinated or incompletely vaccinated children with neurological manifestations due to SARS‐CoV‐2 Omicron infection

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

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