Seizures in febrile children with SARS-CoV-2 infection: clinical features, short-term follow-up

Abstract

Abstract Background: With the emergence of the Omicron variant of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the neurological manifestations associated with this epidemic have garnered increasing attention. The main objective of this study was to compare seizures in febrile children with and without SARS-CoV-2 infection and to conduct short-term follow-up of the SARS-CoV-2-infected patients. Methods: Retrospective analysis of patients admitted to the Children's Hospital of Chongqing Medical University for fever and seizures between October 1 and December 30, 2022.Based on the results of SARS-CoV-2 Reverse Transcription-Polymerase Chain Reaction(RT-PCR), the patients were divided into a Coronavirus disease 2019(COVID-19) positive group and a COVID-19 negative group.In addition, we followed up COVID-19-positive patients for 3 months after their discharge from the hospital.The follow-up included monitoring for post-discharge seizures. Results: Compared with the COVID-19-negative group, the COVID-19-positive group had a higher proportion of seizure duration ≥ 15 minutes(18.7%VS5.1%;P=0.001), seizure ≥ 2 time (54.4%VS41.0%;P=0.024), status epilepticus(15.4%VS5.1%;P=0.005), and Electroencephalogram (EEG) abnormalities(29.4%VS13.6%;P=0.016). Among the 161 individuals under follow-up, 21 (13.0%)experienced a reoccurrence of seizures. Conclusions: Although the incidence of seizure duration ≥15 minutes, number of seizures ≥2 time, and status epilepticus was higher in the COVID-19-positive group, the majority of patients had a favorable prognosis.However, patients with COVID-19 who present with seizures and persistent impaired consciousness need to be alerted to serious neurological disorders such as acute necrotizing encephalopathy.Since some patients may experience a recurrence of seizures within a short period of time, it is important to provide education to guardians about the emergency management of seizures and to follow up with patients over time.