BACKGROUND Little is known about the epidemiology and outcomes of neurologic complications associated with coronavirus disease 2019 (COVID-19) in children. METHODS We performed a cross-sectional study of children 2 months to <18 years of age with COVID-19 discharged from 52 children's hospitals from March 2020 to March 2022. Neurologic complications were defined as encephalopathy, encephalitis, aseptic meningitis, febrile seizure, nonfebrile seizure, brain abscess and bacterial meningitis, Reye's syndrome, and cerebral infarction. We assessed length of stay (LOS), ICU admission, 30 day readmissions, deaths, and hospital costs. We used multivariable logistic regression to identify factors associated with neurologic complications. RESULTS Of 15 137 children hospitalized with COVID-19, 1060 (7.0%) had a concurrent diagnosis of a neurologic complication. The most frequent neurologic complications were febrile seizures (3.9%), nonfebrile seizures (2.3%), and encephalopathy (2.2%). Hospital LOS, ICU admission, ICU LOS, 30 day readmissions, deaths, and hospital costs were higher in children with neurologic complications compared with those without complications. Factors associated with lower odds of neurologic complications included: younger age (adjusted odds ratio [aOR]: 0.97; 95% confidence interval [CI]: 0.96-0.98), occurrence during delta variant predominant time period (aOR: 0.71; 95% CI: 0.57-0.87), presence of a nonneurologic complex chronic condition (aOR: 0.80; 95% CI: 0.69-0.94). The presence of a neurologic complex chronic condition was associated with higher odds of neurologic complication (aOR 4.14, 95% CI 3.48-4.92). CONCLUSIONS Neurologic complications are common in children hospitalized with COVID-19 and are associated with worse hospital outcomes. Our findings emphasize the importance of COVID-19 immunization in children, especially in high-risk populations, such as those with neurologic comorbidity.

中文翻译：

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COVID-19 和儿童急性神经系统并发症。

背景 与 2019 年冠状病毒病 (COVID-19) 相关的儿童神经系统并发症的流行病学和结果知之甚少。方法 我们对 2020 年 3 月至 2022 年 3 月从 52 家儿童医院出院的 2 个月至 <18 岁的 COVID-19 儿童进行了横断面研究。神经系统并发症定义为脑病、脑炎、无菌性脑膜炎、热性惊厥、非发热性惊厥癫痫、脑脓肿和细菌性脑膜炎、雷氏综合征和脑梗塞。我们评估了住院时间 (LOS)、入住 ICU、30 天再入院、死亡和住院费用。我们使用多变量逻辑回归来确定与神经系统并发症相关的因素。结果 15 137 名因 COVID-19 而住院的儿童中，有 1060 名（7. 0%）同时诊断出神经系统并发症。最常见的神经系统并发症是热性惊厥 (3.9%)、非热性惊厥 (2.3%) 和脑病 (2.2%)。与没有并发症的儿童相比，有神经系统并发症的儿童住院时间、入住 ICU、入住 ICU、30 天再入院、死亡和住院费用更高。与神经系统并发症几率较低相关的因素包括：年龄较小（调整后的几率比 [aOR]：0.97；95% 置信区间 [CI]：0.96-0.98），发生在 delta 变异占主导地位的时间段（aOR：0.71；95% CI : 0.57-0.87)，存在非神经性复杂慢性病症 (aOR: 0.80; 95% CI: 0.69-0.94)。神经系统复杂慢性病的存在与神经系统并发症的较高几率相关（aOR 4.14，95% CI 3.48-4.92）。结论 神经系统并发症在因 COVID-19 住院的儿童中很常见，并且与较差的住院结果相关。我们的研究结果强调了 COVID-19 免疫接种对儿童的重要性，尤其是在高危人群中，例如患有神经系统合并症的人群。