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CC BY-NC-ND 4.0 · J Pediatr Infect Dis 2024; 19(05): 287-293
DOI: 10.1055/s-0044-1788678
Original Article

Clinical and Biochemical Features of Kids with COVID-19 Febrile Seizures during the Omicron Wave

Yu Shi
1   Department of Medical Affairs, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China
,
Shijian Miao
2   Department of Gastroenterology, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China
,
Guomei Shen
3   Outpatient and Emergency Management Office, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China
,
Jin Fu
1   Department of Medical Affairs, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China
,
Xuan Gao
3   Outpatient and Emergency Management Office, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China
,
Xiaonan Du
4   Department of Neurology, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China
,
Guoying Huang
5   Heart Canter, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China
,
Shuizhen Zhou
4   Department of Neurology, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China
,
Xiaowen Zhai
6   Department of Hematology, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China
› Author Affiliations Funding This work was supported by the Shanghai Hospital Association (202150028) and the Shanghai Hospital Development Center (2022SKMR-17).
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Abstract

Objective Mild symptoms are the norm for children with coronavirus disease-2019 (COVID-19), but data on the Omicron form are few. One of the most frequent neurological symptoms of COVID-19 in children is febrile seizure (FS).

Methods Patients with FS who visited the pediatric fever clinic between December 6 and December 31, 2022, when the Omicron version of SARS-CoV-2 was the predominant strain, were included in this retrospective, single-center analysis.

Results Children who tested positive for COVID-19 had a 5.58% incidence of FSs. Compared to patients without COVID-19, a greater percentage of COVID-19 patients (29.5 vs. 7.5%, p < 0.01) experienced complex FSs. In the COVID-19-positive group, four cases were critically unwell and were admitted to the Intensive Care Unit (1.4 vs. 0%, p < 0.01), and the admission proportion was greater (18.9 vs. 1.9%, p < 0.01). The proportion of lactic acid and IL-6 increase was larger in the COVID-19-positive group (33.5 vs. 21.5%, 22.1 vs. 17.8%, p = 0.022, p = 0.006, respectively).

Conclusion Infections with COVID-19 in children have been linked to FSs in the Omicron era. To fully understand the neuropathogenesis of seizures in children with COVID-19, more research is required.

Keywords

febrile seizures - COVID-19 - Omicron - pandemic - convulsions

Author's Contributions

Y.S., S.M., and X.Z. designed the study, participated in its implementation, analyzed, and wrote the initial draft of the manuscript. G.S., J.F., X.G., and X.D. collected the data and carried out the initial analyses. G.H., X.Z., and S.Z. reviewed the study results. X.Z. and S.Z. conceptualized and designed the study, coordinated and supervised data collection, and critically reviewed the manuscript. All authors approved the final manuscript and agreed to be responsible for all aspects of the work.




Publication History

Received: 11 January 2024

Accepted: 09 July 2024

Article published online:
01 August 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Morgello S. Coronaviruses and the central nervous system. J Neurovirol 2020; 26 (04) 459-473
    CrossrefPubMedSearch in Google Scholar
  • 2 Carod-Artal FJ. Neurological complications of coronavirus and COVID-19. Rev Neurol 2020; 70 (09) 311-322
    CrossrefPubMedSearch in Google Scholar
  • 3 Asadi-Pooya AA. Seizures associated with coronavirus infections. Seizure 2020; 79: 49-52
    CrossrefPubMedSearch in Google Scholar
  • 4 LaRovere KL, Riggs BJ, Poussaint TY. et al; Overcoming COVID-19 Investigators. Neurologic involvement in children and adolescents hospitalized in the United States for COVID-19 or multisystem inflammatory syndrome. JAMA Neurol 2021; 78 (05) 536-547
    CrossrefPubMedSearch in Google Scholar
  • 5 Nikbakht F, Mohammadkhanizadeh A, Mohammadi E. How does the COVID-19 cause seizure and epilepsy in patients? The potential mechanisms. Mult Scler Relat Disord 2020; 46: 102535
    CrossrefPubMedSearch in Google Scholar
  • 6 Kurd M, Hashavya S, Benenson S, Gilboa T. Seizures as the main presenting manifestation of acute SARS-CoV-2 infection in children. Seizure 2021; 92: 89-93
    CrossrefPubMedSearch in Google Scholar
  • 7 Leung AK, Hon KL, Leung TN. Febrile seizures: an overview. Drugs Context 2018; 7: 212536
    CrossrefPubMedSearch in Google Scholar
  • 8 Trinka E, Cock H, Hesdorffer D. et al. A definition and classification of status epilepticus–report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia 2015; 56 (10) 1515-1523
    CrossrefPubMedSearch in Google Scholar
  • 9 Patterson JL, Carapetian SA, Hageman JR, Kelley KR. Febrile seizures. Pediatr Ann 2013; 42 (12) 249-254
    CrossrefPubMedSearch in Google Scholar
  • 10 Smith DK, Sadler KP, Benedum M. Febrile seizures: risks, evaluation, and prognosis. Am Fam Physician 2019; 99 (07) 445-450
    PubMedSearch in Google Scholar
  • 11 Laino D, Mencaroni E, Esposito S. Management of pediatric febrile seizures. Int J Environ Res Public Health 2018; 15 (10) 2232
    CrossrefPubMedSearch in Google Scholar
  • 12 Viviani B, Bartesaghi S, Gardoni F. et al. Interleukin-1beta enhances NMDA receptor-mediated intracellular calcium increase through activation of the Src family of kinases. J Neurosci 2003; 23 (25) 8692-8700
    CrossrefPubMedSearch in Google Scholar
  • 13 Hautala M, Arvila J, Pokka T. et al. Respiratory viruses and febrile response in children with febrile seizures: a cohort study and embedded case-control study. Seizure 2021; 84: 69-77
    CrossrefPubMedSearch in Google Scholar
  • 14 Cadet K, Boegner J, Ceneviva GD, Thomas NJ, Krawiec C. Evaluation of febrile seizure diagnoses associated with COVID-19. J Child Neurol 2022; 37 (05) 410-415
    CrossrefPubMedSearch in Google Scholar
  • 15 Berg AT, Berkovic SF, Brodie MJ. et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia 2010; 51 (04) 676-685
    CrossrefPubMedSearch in Google Scholar
  • 16 Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr 2020; 109 (06) 1088-1095
    CrossrefPubMedSearch in Google Scholar
  • 17 Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet 2020; 395 (10237): 1607-1608
    CrossrefPubMedSearch in Google Scholar
  • 18 Kahn R, Berg S, Berntson L. et al. Population-based study of multisystem inflammatory syndrome associated with COVID-19 found that 36% of children had persistent symptoms. Acta Paediatr 2022; 111 (02) 354-362
    CrossrefPubMedSearch in Google Scholar
  • 19 Iacobucci G. Covid-19: runny nose, headache, and fatigue are commonest symptoms of omicron, early data show. BMJ 2021; 375 (3103) n3103
    CrossrefPubMedSearch in Google Scholar
  • 20 Misra S, Kolappa K, Prasad M. et al. Frequency of neurologic manifestations in COVID-19: a systematic review and meta-analysis. Neurology 2021; 97 (23) e2269-e2281
    CrossrefPubMedSearch in Google Scholar
  • 21 Ludvigsson JF. Convulsions in children with COVID-19 during the Omicron wave. Acta Paediatr 2022; 111 (05) 1023-1026
    CrossrefPubMedSearch in Google Scholar
  • 22 Han MJ, Heo JH, Hwang JS, Jang YT, Lee M, Kim SJ. Incidence of febrile seizures in children with COVID-19. J Clin Med 2023; 12 (03) 1076
    CrossrefPubMedSearch in Google Scholar
  • 23 Iijima H, Kubota M, Ogimi C. Change in seizure incidence in febrile children with COVID-19 in the era of omicron variant of concern. J Pediatric Infect Dis Soc 2022; 11 (11) 514-517
    CrossrefPubMedSearch in Google Scholar
  • 24 Meinhardt J, Radke J, Dittmayer C. et al. Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19. Nat Neurosci 2021; 24 (02) 168-175
    CrossrefPubMedSearch in Google Scholar
  • 25 Burks SM, Rosas-Hernandez H, Alejandro Ramirez-Lee M, Cuevas E, Talpos JC. Can SARS-CoV-2 infect the central nervous system via the olfactory bulb or the blood-brain barrier?. Brain Behav Immun 2021; 95: 7-14
    CrossrefPubMedSearch in Google Scholar
  • 26 Taytard J, Prevost B, Schnuriger A. et al. SARS-CoV-2 B.1.1.529 (Omicron) variant causes an unprecedented surge in children hospitalizations and distinct clinical presentation compared to the SARS-CoV-2 B.1.617.2 (Delta) variant. Front Pediatr 2022; 10: 932170
    CrossrefPubMedSearch in Google Scholar
  • 27 Mohamed ZA, Tang C, Thokerunga E, Deng Y, Fan J. Pediatric infection with the Omicron variant increases the risks of febrile seizures among COVID-19 infected children. Front Pediatr 2023; 11: 1226403
    CrossrefPubMedSearch in Google Scholar
  • 28 Lazarte-Rantes C, Guevara-Castañón J, Romero L, Guillén-Pinto D. Acute necrotizing encephalopathy associated with SARS-CoV-2 exposure in a pediatric patient. Cureus 2021; 13 (05) e15018
    PubMedSearch in Google Scholar
  • 29 Lin JE, Asfour A, Sewell TB. et al. Neurological issues in children with COVID-19. Neurosci Lett 2021; 743: 135567
    CrossrefPubMedSearch in Google Scholar
  • 30 Chen JR, Jin MF, Tang L, Liu YY, Ni H. Acute phase serum leptin, adiponectin, interleukin-6, and visfatin are altered in Chinese children with febrile seizures: a cross-sectional study. Front Endocrinol (Lausanne) 2020; 11: 531
    CrossrefPubMedSearch in Google Scholar
  • 31 Peckham H, de Gruijter NM, Raine C. et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nat Commun 2020; 11 (01) 6317
    CrossrefPubMedSearch in Google Scholar
  • 32 Azkur AK, Akdis M, Azkur D. et al. Immune response to SARS-CoV-2 and mechanisms of immunopathological changes in COVID-19. Allergy 2020; 75 (07) 1564-1581
    CrossrefPubMedSearch in Google Scholar
  • 33 Dubé CM, Brewster AL, Baram TZ. Febrile seizures: mechanisms and relationship to epilepsy. Brain Dev 2009; 31 (05) 366-371
    CrossrefPubMedSearch in Google Scholar