Tuesday, October 25, 2022

Neurological Complications Associated With Worse Outcomes in Youth Hospitalized for COVID-19

About 1 in 15 children and adolescents hospitalized for COVID-19 experiences neurologic complications, suggests a study in Pediatrics. Among those complications are an increased risk of admission to the intensive care unit (ICU), hospital readmissions, and death.

For the study, James W. Antoon, M.D., Ph.D., M.P.H., of the Children’s Hospital at Vanderbilt and colleagues analyzed data on youth aged 2 months up to 18 years who were hospitalized for COVID-19 between March 2020 and March 2022. The researchers examined reports of neurologic complications (including encephalopathy, encephalitis, aseptic meningitis, seizures, cerebral infarction, and more) during the hospitalization of the youth.

A total of 15,137 children and adolescents hospitalized for COVID-19 were included in the analysis; 1,060 (7.0%) had at least one neurologic complication. The most common neurologic complication was febrile seizures (3.8%) followed by nonfebrile seizures (2.3%) and encephalopathy (2.2%). The least common neurologic complications were brain abscess or bacterial meningitis and cerebral infarction (0.13% and 0.05%, respectively).

Antoon and colleagues compared the hospital outcomes (such as length of stay, readmissions within 30 days of discharge, and costs associated with hospitalization) of children and adolescents with COVID-19 who experienced neurologic complications with those who did not have neurologic complications. They found that youth with neurologic complications had more ICU admissions (29.8% vs. 21.8%), longer ICU length of stay (3.2 days vs. 2.5 days), and more in-hospital deaths (1.8% vs 0.6%). Youth with neurologic complications also had more 30-day readmissions and higher hospital costs compared with those without neurologic complications.

The researchers noted that youth with chronic neurological conditions had greater odds of experiencing neurologic complications during hospitalization for COVID-19. In contrast, youth who were older, received remdesivir or dexamethasone treatment, and/or were infected by the SARS-CoV-2 delta variant had lower odds of neurologic complications.

“Our findings emphasize the importance of COVID-19 immunization in children, especially in high-risk populations, such as those with neurologic comorbidity,” Antoon and colleagues concluded.

For related information, see the Psychiatric Services article “Mental Health Conditions Among Children and Adolescents With a COVID-19 Diagnosis.”

(Image: iStock/FangXiaNuo)

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