COVID-19 neuro complications, long-term symptoms in kids

Two new US studies describe pediatric COVID-19, one finding that 7.0% of hospitalized children developed neurologic complications such as seizures, and the other showing that even mild infections can lead to long COVID.7% have seizures, brain damageIn a large, multicenter study published today in Pediatrics, a team led by Vanderbilt University researchers followed 15,137 COVID-19 patients aged 2 months to 17 years released from 52 US children's hospitals participating in the Pediatric Health Information System database from March 2020 to March 2022.Of the 15,137 patients, 82.1% had a primary COVID-19 diagnosis, and 17.9% had a secondary diagnosis of COVID-19 and a related complication.

A total of 37.1% of children had a complex chronic condition (CCC), and 9.8% had at least one previously diagnosed neurologic CCC.Seven percent of patients developed a neurologic complication, the most common of which were fever-triggered seizures (3.9%), non–fever-related seizures (2.3%), and encephalopathy (brain damage or disease) (2.2%).Children with neurologic conditions had longer hospital stays, higher hospital costs, more intensive care unit (ICU) admissions (29.8% vs 21.8%), longer ICU stays (3.2 vs 2.5 days), more hospital readmissions, and higher rates of in-hospital death (1.8% vs 0.6%) than those without these conditions.Factors tied to a lower likelihood of neurologic complications included younger age (adjusted odds ratio [aOR], 0.97), infection during the Delta variant surge (aOR, 0.71), and presence of a nonneurologic CCC (aOR, 0.80).

Lower odds of a neurologic complication were also associated with COVID-19 treatment with the antiviral drug remdesivir and/or dexamethasone, a corticosteroid.