Background

Children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can experience neurological symptoms, but limited data are available on neurological symptoms associated with other respiratory infections. We compared proportions of neurological symptoms in children hospitalized with seizures and respiratory infections, including SARS-CoV-2, influenza, and endemic coronaviruses.

Methods

A retrospective cohort study was performed on children admitted for seizures who had positive respiratory polymerase chain reactions for SARS-CoV-2, coronavirus NL63, coronavirus OC34, influenza (A and B), adenovirus, Mycoplasma pneumoniae, or parainfluenza 3 or 4. Primary outcomes were rates of new neurological diagnoses and mortality.

Results

A total of 883 children were included. Mortality rates ranged from 0% with M. pneumoniae to 4.9% with parainfluenza 4. Strokes were observed with all infections except for coronavirus OC43 and M. pneumoniae, with the highest rates in parainfluenza 4 (4.9%) and SARS-CoV-2 (5.9%). Compared with other infections, children with SARS-CoV-2 were older, had higher rates of stroke, and lower rates of intubation. The most common brain magnetic resonance imaging (MRI) abnormality was diffusion restriction. Abnormal MRI rates were lower in SARS-CoV-2, compared with patients with other coronavirus (OC). However, rates of stroke, encephalopathy, hypoxic-ischemic encephalopathy, and meningoencephalitis were similar between SARS-CoV-2 and influenza cohorts.

Conclusions

In children hospitalized with seizures, higher rates of stroke were observed in SARS-CoV-2 versus OC. Similar rates of neurological symptoms were observed in patients with SARS-CoV-2 and those with influenza. Strokes can occur in children with these viral infections, particularly SARS-CoV-2.

中文翻译：

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因癫痫和呼吸道感染住院的儿童的神经系统并发症：SARS-CoV-2 与其他呼吸道感染之间的比较

 背景

感染严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 的儿童可能会出现神经系统症状，但与其他呼吸道感染相关的神经系统症状的数据有限。我们比较了因癫痫和呼吸道感染（包括 SARS-CoV-2、流感和地方性冠状病毒）住院的儿童的神经系统症状比例。

 方法

对因癫痫入院的 SARS-CoV-2、冠状病毒 NL63、冠状病毒 OC34、流感（甲型和乙型）、腺病毒、肺炎支原体或副流感 3 或 4 型呼吸道聚合酶链反应呈阳性的儿童进行了一项回顾性队列研究。结果是新的神经系统诊断率和死亡率。

 结果

共有 883 名儿童被纳入其中。肺炎支原体的死亡率为 0%，副流感 4 型的死亡率为 4.9%。除冠状病毒 OC43 和肺炎支原体外，所有感染均观察到中风，其中副流感 4 型（4.9%）和 SARS-CoV-2 的死亡率最高（4.9%）。 5.9%）。与其他感染者相比，感染 SARS-CoV-2 的儿童年龄较大，中风发生率较高，插管率较低。最常见的脑部磁共振成像（MRI）异常是弥散受限。与其他冠状病毒 (OC) 患者相比，SARS-CoV-2 患者的 MRI 异常率较低。然而，SARS-CoV-2 和流感队列之间的中风、脑病、缺氧缺血性脑病和脑膜脑炎的发生率相似。

 结论

在因癫痫住院的儿童中，SARS-CoV-2 患者的中风发生率高于 OC 患者。在 SARS-CoV-2 患者和流感患者中观察到神经系统症状的发生率相似。感染这些病毒（尤其是 SARS-CoV-2）的儿童可能会发生中风。