Clinical features of febrile seizures in children with COVID-19: an observational study from a tertiary care hospital in China.

Cuiyun Fang, Yuan Zhou, Wei Fan, Chunsheng Zhang, Yi Yang
Author Information
  1. Cuiyun Fang: Department of Nursing, Liyang People's Hospital, Liyang, China.
  2. Yuan Zhou: Department of Nursing, Liyang People's Hospital, Liyang, China.
  3. Wei Fan: Department of Pediatrics, Liyang People's Hospital, Liyang, China.
  4. Chunsheng Zhang: Department of Pediatrics, Liyang People's Hospital, Liyang, China.
  5. Yi Yang: Department of Pediatrics, Liyang People's Hospital, Liyang, China.

Abstract

Background: Febrile seizures are a common neurologic manifestation in children with coronavirus disease 2019 (COVID-19). Compared to seasonal respiratory viruses, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a pronounced neurological impact, with the result that febrile seizures with COVID-19 may exhibit unique clinical features.
Materials and methods: We conducted a retrospective study in a tertiary care hospital in China. We collected medical record information on febrile seizures with COVID-19, including demographic characteristics, clinical features, laboratory tests, and disease burden. Subsequently, the data were then analyzed descriptively.
Results: A total of 103 children diagnosed with febrile seizures and positive COVID-19 PCR results were included in our study. Among them, 81 (78.6%) were males and 22 (21.4%) were females. The age of onset of febrile seizures ranged from 14 to 57 months, with a mean age of 34.9 ± 6.24 months. Complex febrile seizures were observed in 34 (33%) cases. Antiseizure medications were administered to 24 (23.3%) patients. Laboratory tests showed a white blood cell count of (27.05 ± 8.20) × 10/µl, a neutrophil count of (20.09 ± 5.66) × 10/µl and a lymphocyte count of (6.44 ± 1.86) × 10/µl. A creatine kinase level was significantly elevated, with a mean value of (412.00 ± 158.96) U/L. The mean length of stay was 4.36 days. Twelve patients (11.7%) required intensive care services, but there were no deaths or patients remaining on antiseizure medications after discharge.
Conclusion: In the post-epidemic era of COVID-19, pediatric clinicians should be aware of the changing clinical features of febrile seizures associated with COVID-19. The average age of onset has increased, with a higher proportion of males. Length of stay and hospitalization costs did not increase significantly. The prognosis remained favorable, although a small number of children required intensive care services during the acute phase.

Keywords

References

  1. Epilepsia. 2023 Oct;64(10):2539-2549 [PMID: 37466925]
  2. Eur J Paediatr Neurol. 2022 Mar;37:139-154 [PMID: 35287009]
  3. J Clin Med. 2023 Jan 30;12(3): [PMID: 36769723]
  4. BMC Pediatr. 2016 Dec 3;16(1):202 [PMID: 27914475]
  5. Pediatr Int. 2023 Jan;65(1):e15461 [PMID: 36572414]
  6. Front Pediatr. 2022 Jan 13;9:801321 [PMID: 35096712]
  7. Biosci Trends. 2022;16(6):381-385 [PMID: 36567122]
  8. Brain Dev. 2020 Jan;42(1):28-34 [PMID: 31604594]
  9. Arq Neuropsiquiatr. 2022 Aug;80(8):779-785 [PMID: 36252585]
  10. Sci Rep. 2021 Oct 12;11(1):20254 [PMID: 34642411]
  11. Drugs Context. 2018 Jul 16;7:212536 [PMID: 30038660]
  12. JAMA Neurol. 2021 May 1;78(5):536-547 [PMID: 33666649]
  13. Seizure. 2020 Jul;79:49-52 [PMID: 32416567]
  14. Rev Neurosci. 2021 Feb 15;32(6):671-691 [PMID: 33583157]
  15. J Thorac Dis. 2020 Dec;12(12):7429-7441 [PMID: 33447431]
  16. J Clin Med. 2021 Apr 16;10(8): [PMID: 33923719]
  17. J Pediatric Infect Dis Soc. 2022 Dec 5;11(11):514-517 [PMID: 35984115]
  18. Epilepsia. 2009 Jan;50 Suppl 1:2-6 [PMID: 19125841]
  19. Am J Emerg Med. 2022 Sep;59:133-140 [PMID: 35849960]
  20. Am J Clin Pathol. 2021 Feb 11;155(3):364-375 [PMID: 33269374]
  21. Physiol Rev. 2018 Jan 1;98(1):477-504 [PMID: 29351513]
  22. Eur J Pediatr. 2021 Sep;180(9):2993-2999 [PMID: 33866403]
  23. J Nepal Health Res Counc. 2014 Sep-Oct;12(28):162-6 [PMID: 26032052]
  24. Nat Commun. 2020 Dec 9;11(1):6317 [PMID: 33298944]
  25. Brain. 2023 Apr 19;146(4):1648-1661 [PMID: 36087305]
  26. Nat Rev Immunol. 2020 Jul;20(7):442-447 [PMID: 32528136]
  27. Nature. 2020 Dec;588(7837):315-320 [PMID: 32846427]
  28. Eur J Neurol. 2021 Oct;28(10):3411-3417 [PMID: 32997370]
  29. Children (Basel). 2020 Nov 17;7(11): [PMID: 33212914]
  30. Dev Med Child Neurol. 2020 Nov;62(11):1245-1249 [PMID: 32748466]
  31. J Am Heart Assoc. 2022 May 3;11(9):e024393 [PMID: 35475362]
  32. Front Public Health. 2020 Apr 29;8:152 [PMID: 32411652]
  33. Pediatrics. 2022 Nov 1;150(5): [PMID: 35949041]
  34. Pediatrics. 2011 Feb;127(2):389-94 [PMID: 21285335]

Word Cloud

Created with Highcharts 10.0.0seizuresfebrileCOVID-19childrenfeaturesclinicalcarediseasestudyagemeanpatientscount × 10/µlcoronavirusrespiratoryacutetertiaryhospitalChinatestsburdenmalesonsetmonths3424medications20significantlystayrequiredintensiveservicesBackground:Febrilecommonneurologicmanifestation2019Comparedseasonalvirusesseveresyndrome2SARS-CoV-2pronouncedneurologicalimpactresultmayexhibituniqueMaterialsmethods:conductedretrospectivecollectedmedicalrecordinformationincludingdemographiccharacteristicslaboratorySubsequentlydataanalyzeddescriptivelyResults:total103diagnosedpositivePCRresultsincludedAmong81786%22214%femalesranged14579 ± 6Complexobserved33%casesAntiseizureadministered233%Laboratoryshowedwhitebloodcell2705 ± 8neutrophil09 ± 566lymphocyte644 ± 186creatinekinaselevelelevatedvalue41200 ± 15896U/Llength436daysTwelve117%deathsremainingantiseizuredischargeConclusion:post-epidemicerapediatriccliniciansawarechangingassociatedaverageincreasedhigherproportionLengthhospitalizationcostsincreaseprognosisremainedfavorablealthoughsmallnumberphaseClinicalCOVID-19:observational

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