Neurologic manifestations common in hospitalized children with SARS-CoV-2, MIS

Children hospitalized with acute SARS-CoV-2 and multisystem inflammatory syndrome (MIS) tend to experience neurologic manifestations, according to a study in Indonesia.

This multicentre, cross-sectional study included a total of 1,397 children who were hospitalized with positive SARS-CoV-2 test or clinical diagnosis of SARS-CoV-2-related condition and MIS between June 2020 and June 2023. The authors performed multivariable logistic regression to identify the risk factors for neurologic manifestations.

Of the children, 1,283 (91.8 percent) were diagnosed with acute SARS-CoV-2 and 114 (8.2 percent) with MIS. Neurologic manifestations occurred in more than half (51.2 percent) of the patients, with seizures (26.3 percent) and acute encephalopathy (17.5 percent) being the most common in the overall cohort.

One in four (25 percent) children were admitted to the intensive care unit (ICU). Patients with acute SARS-CoV-2 and non-neurologic manifestations were more likely to be admitted to ICU than those suffering from from MIS and neurologic manifestations (p<0.0001).

Overall, the mortality rate stood at 16.1 percent. Notably, many of these deaths occurred in children with neurologic manifestations (26.3 percent).

In multivariate analysis, the following risk factors correlated with neurologic manifestations: younger age, fever, anorexia, and pre-existing neurology, respiratory, and renal urology conditions (p<0.05).

“The COVID-19 pandemic is a prevalent condition caused by SARS-CoV-2,” the authors said. “Several studies have shown that affected patients can experience neurologic manifestations.”