Predicting factors for acute encephalopathy in febrile seizure children with SARS-CoV-2 omicron variant: a retrospective study
Abstract Background SARS-CoV-2 posed a threat to children during the early phase of Omicron wave because many patients presented with febrile seizures. The study aimed to investigate predicting factors for acute encephalopathy of children infected by SARS-CoV-2 Omicron variant presenting with febril...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12887-024-04699-x |
| _version_ | 1797233226099458048 |
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| author | Ching-Min Tang Cheng-Yen Kuo Chen-Wei Yen Jainn-Jim Lin Yu-Chia Hsieh Shao-Hsuan Hsia Oi-Wa Chan En-Pei Lee Po-Cheng Hung Huei-Shyong Wang Kuang-Lin Lin Cheng-Hsun Chiu |
| author_facet | Ching-Min Tang Cheng-Yen Kuo Chen-Wei Yen Jainn-Jim Lin Yu-Chia Hsieh Shao-Hsuan Hsia Oi-Wa Chan En-Pei Lee Po-Cheng Hung Huei-Shyong Wang Kuang-Lin Lin Cheng-Hsun Chiu |
| author_sort | Ching-Min Tang |
| collection | DOAJ |
| description | Abstract Background SARS-CoV-2 posed a threat to children during the early phase of Omicron wave because many patients presented with febrile seizures. The study aimed to investigate predicting factors for acute encephalopathy of children infected by SARS-CoV-2 Omicron variant presenting with febrile seizures. Methods The retrospective study analyzed data from pediatric patients who visited the emergency department of Chang Gung Memorial Hospital in Taiwan between April and July 2022. We specifically focused on children with COVID-19 who presented with febrile seizures, collecting demographic, clinical, and laboratory data at the pediatric emergency department, as well as final discharge diagnoses. Subsequently, we conducted a comparative analysis of the clinical and laboratory characteristics between patients diagnosed with acute encephalopathy and those with other causes of febrile seizures. Results Overall, 10,878 children were included, of which 260 patients presented with febrile seizures. Among them, 116 individuals tested positive for SARS-CoV-2 and of them, 14 subsequently developed acute encephalopathy (12%). Those with acute encephalopathy displayed distinctive features, including older age (5.1 vs. 2.6 years old), longer fever duration preceding the first seizure (1.6 vs. 0.9 days), cluster seizure (50% vs. 16.7%), status epilepticus (50% vs. 13.7%) and occurrences of bradycardia (26.8% vs. 0%) and hypotension (14.3% vs. 0%) in the encephalopathy group. Besides, the laboratory findings in the encephalopathy group are characterized by hyperglycemia (mean (95% CI) 146 mg/dL (95% CI 109–157) vs. 108 mg/dL (95% CI 103–114) and metabolic acidosis (mean (95% CI) pH 7.29(95% CI 7.22–7.36) vs. 7.39 (95%CI 7.37–7.41)). Conclusions In pediatric patients with COVID-19-related febrile seizures, the occurrence of seizures beyond the first day of fever, bradycardia, clustered seizures, status epilepticus, hyperglycemia, and metabolic acidosis should raise concerns about acute encephalitis/encephalopathy. However, the highest body temperature and the severity of leukocytosis or C-reactive protein levels were not associated with poor outcomes. |
| first_indexed | 2024-04-24T16:12:48Z |
| format | Article |
| id | doaj.art-01a76bff01e84477aa9db33a6bf360a8 |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-04-24T16:12:48Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-01a76bff01e84477aa9db33a6bf360a82024-03-31T11:35:45ZengBMCBMC Pediatrics1471-24312024-03-012411910.1186/s12887-024-04699-xPredicting factors for acute encephalopathy in febrile seizure children with SARS-CoV-2 omicron variant: a retrospective studyChing-Min Tang0Cheng-Yen Kuo1Chen-Wei Yen2Jainn-Jim Lin3Yu-Chia Hsieh4Shao-Hsuan Hsia5Oi-Wa Chan6En-Pei Lee7Po-Cheng Hung8Huei-Shyong Wang9Kuang-Lin Lin10Cheng-Hsun Chiu11Division of Pediatric Neurology, Chang Gung Children’s Hospital and Chang Gung Memorial Hospital, Kwei-ShanDivision of Pediatric Neurology, Chang Gung Children’s Hospital and Chang Gung Memorial Hospital, Kwei-ShanSchool of Medicine, College of Medicine, Chang Gung UniversityDivision of Pediatric Neurology, Chang Gung Children’s Hospital and Chang Gung Memorial Hospital, Kwei-ShanSchool of Medicine, College of Medicine, Chang Gung UniversityDivision of Pediatric Critical Care and Pediatric Neurocritical Care Center, Chang Gung Children’s Hospital and Chang Gung Memorial HospitalDivision of Pediatric Critical Care and Pediatric Neurocritical Care Center, Chang Gung Children’s Hospital and Chang Gung Memorial HospitalDivision of Pediatric Critical Care and Pediatric Neurocritical Care Center, Chang Gung Children’s Hospital and Chang Gung Memorial HospitalDivision of Pediatric Neurology, Chang Gung Children’s Hospital and Chang Gung Memorial Hospital, Kwei-ShanDivision of Pediatric Neurology, Chang Gung Children’s Hospital and Chang Gung Memorial Hospital, Kwei-ShanDivision of Pediatric Neurology, Chang Gung Children’s Hospital and Chang Gung Memorial Hospital, Kwei-ShanDivision of Infectious Diseases, Department of Pediatrics, Chang Gung Memorial HospitalAbstract Background SARS-CoV-2 posed a threat to children during the early phase of Omicron wave because many patients presented with febrile seizures. The study aimed to investigate predicting factors for acute encephalopathy of children infected by SARS-CoV-2 Omicron variant presenting with febrile seizures. Methods The retrospective study analyzed data from pediatric patients who visited the emergency department of Chang Gung Memorial Hospital in Taiwan between April and July 2022. We specifically focused on children with COVID-19 who presented with febrile seizures, collecting demographic, clinical, and laboratory data at the pediatric emergency department, as well as final discharge diagnoses. Subsequently, we conducted a comparative analysis of the clinical and laboratory characteristics between patients diagnosed with acute encephalopathy and those with other causes of febrile seizures. Results Overall, 10,878 children were included, of which 260 patients presented with febrile seizures. Among them, 116 individuals tested positive for SARS-CoV-2 and of them, 14 subsequently developed acute encephalopathy (12%). Those with acute encephalopathy displayed distinctive features, including older age (5.1 vs. 2.6 years old), longer fever duration preceding the first seizure (1.6 vs. 0.9 days), cluster seizure (50% vs. 16.7%), status epilepticus (50% vs. 13.7%) and occurrences of bradycardia (26.8% vs. 0%) and hypotension (14.3% vs. 0%) in the encephalopathy group. Besides, the laboratory findings in the encephalopathy group are characterized by hyperglycemia (mean (95% CI) 146 mg/dL (95% CI 109–157) vs. 108 mg/dL (95% CI 103–114) and metabolic acidosis (mean (95% CI) pH 7.29(95% CI 7.22–7.36) vs. 7.39 (95%CI 7.37–7.41)). Conclusions In pediatric patients with COVID-19-related febrile seizures, the occurrence of seizures beyond the first day of fever, bradycardia, clustered seizures, status epilepticus, hyperglycemia, and metabolic acidosis should raise concerns about acute encephalitis/encephalopathy. However, the highest body temperature and the severity of leukocytosis or C-reactive protein levels were not associated with poor outcomes.https://doi.org/10.1186/s12887-024-04699-xPediatricSARS-CoV-2COVID-19Febrile seizuresEncephalopathyPredictive factor |
| spellingShingle | Ching-Min Tang Cheng-Yen Kuo Chen-Wei Yen Jainn-Jim Lin Yu-Chia Hsieh Shao-Hsuan Hsia Oi-Wa Chan En-Pei Lee Po-Cheng Hung Huei-Shyong Wang Kuang-Lin Lin Cheng-Hsun Chiu Predicting factors for acute encephalopathy in febrile seizure children with SARS-CoV-2 omicron variant: a retrospective study BMC Pediatrics Pediatric SARS-CoV-2 COVID-19 Febrile seizures Encephalopathy Predictive factor |
| title | Predicting factors for acute encephalopathy in febrile seizure children with SARS-CoV-2 omicron variant: a retrospective study |
| title_full | Predicting factors for acute encephalopathy in febrile seizure children with SARS-CoV-2 omicron variant: a retrospective study |
| title_fullStr | Predicting factors for acute encephalopathy in febrile seizure children with SARS-CoV-2 omicron variant: a retrospective study |
| title_full_unstemmed | Predicting factors for acute encephalopathy in febrile seizure children with SARS-CoV-2 omicron variant: a retrospective study |
| title_short | Predicting factors for acute encephalopathy in febrile seizure children with SARS-CoV-2 omicron variant: a retrospective study |
| title_sort | predicting factors for acute encephalopathy in febrile seizure children with sars cov 2 omicron variant a retrospective study |
| topic | Pediatric SARS-CoV-2 COVID-19 Febrile seizures Encephalopathy Predictive factor |
| url | https://doi.org/10.1186/s12887-024-04699-x |
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