Abstract
Background and Aim: The COVID-19 pandemic caused by the SARS-CoV-2 virus has had a significant global impact, but its neurological manifestations in children have received limited attention. The aim of this study was to prospectively examine the neurological complications, identify mortality risk factors, and assess the predictive value of biomarkers in pediatric COVID-19 patients.Methods A prospective cohort study was conducted from 2020 to 2023. Children aged from the neonatal period to 13 years, hospitalized with confirmed COVID-19, were included. Data on demographics, neurological comorbidities, symptoms, neurological examination findings, radiological and electrophysiological results, laboratory findings, treatments, and outcomes were collected. Chi-square tests and ROC curves were performed.Results Among the 66 hospitalized children, seizures (59.1%) and altered consciousness (30.3%) were common neurological manifestations. The occurrence of seizures correlated significantly with gender, with males having a higher likelihood of developing epilepsy (P = 0.0044). Seizures were also found to be a risk factor for death, as the majority of children who died had experienced seizures (P = 0.046). Encephalopathy and encephalopathy in MIS-C were also associated with increased mortality (P = 0.013, < 0.001, respectively). Treatment with Dixon negatively impacted outcomes (P = 0.006), while Immunoglobulins had a positive effect (0.019). Biomarkers including CRP, GPT, BUN, and creatinine were all found to be correlated with death, with elevated values indicating higher mortality risk (P < 0.001). Finally, Mechanical ventilation was associated with higher mortality rates (P = 0.008).Conclusion This study provides significant contributions to our understanding of COVID-19 in children, particularly in terms of clinical and neurological aspects, risk factors, and prognosis. The findings emphasize the importance of early detection, monitoring of biomarkers, and the incorporation of these insights into healthcare policies. By recognizing the unique challenges and implications of COVID-19 in pediatric patients, healthcare providers can enhance patient care and optimize outcomes in the midst of the ongoing pandemic.