Clinical characteristics of unvaccinated or incompletely vaccinated children with neurological manifestations due to SARS‐CoV‐2 Omicron infection

Author:

Tso Winnie Wan‐Yee12,Kwan Mike Yat‐Wah3,Kwok Janette Siu‐Yin4,Tsang Jessica Oi‐Ling56,Yip Cyril Chik‐Yan5,Leung Lok‐Kan1,Li Cuixin1,Wang Yuliang1,Chow Mathew Siu‐Chun1,Tsang Anita Man‐Ching1,Chim Stella1,Chow Chin‐Ying1,Ho Alvin Chi‐Chung1,Chan Sophelia Hoi‐Shan1,Tai Shuk‐Mui7,Lee Wing‐Cheong7,Chan Victor Chi‐Man7,Yau Eric Kin‐Cheong3,Sun Jacquelyne Ka‐Li8,Chow Hei‐Man89,Lau Yu‐Lung1,Ip Patrick1,Chan Jasper Fuk‐Woo5610ORCID

Affiliation:

1. Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine The University of Hong Kong Pokfulam Hong Kong Special Administrative Region China

2. State Key Laboratory of Brain & Cognitive Sciences The University of Hong Kong Pokfulam Hong Kong Special Administrative Region China

3. Department of Paediatrics and Adolescent Medicine Princess Margaret Hospital Hong Kong Special Administrative Region China

4. Department of Pathology School of Clinical Medicine, Li Ka Shing Faculty of Medicine The University of Hong Kong Pokfulam Hong Kong Special Administrative Region China

5. State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology School of Clinical Medicine, Li Ka Shing Faculty of Medicine The University of Hong Kong Pokfulam Hong Kong Special Administrative Region China

6. Centre for Virology, Vaccinology and Therapeutics, Hong Kong Science and Technology Park, Sha Tin, Hong Kong Special Administrative Region China

7. Department of Paediatrics and Adolescent Medicine Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong Special Administrative Region China

8. School of Life Sciences The Chinese University of Hong Kong Shatin Hong Kong Special Administrative Region China

9. Gerald Choa Neuroscience Centre The Chinese University of Hong Kong Shatin Hong Kong Special Administrative Region China

10. Department of Infectious Diseases and Microbiology The University of Hong Kong‐Shenzhen Hospital Shenzhen Guangdong China

Abstract

AbstractOmicron generally causes milder disease than previous strains of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), especially in fully vaccinated individuals. However, incompletely vaccinated children may develop Omicron‐related complications such as those affecting the central nervous system. To characterize the spectrum of clinical manifestations of neuro‐COVID and to identify potential biomarkers associated with clinical outcomes, we recruited 15 children hospitalized for Omicron‐related neurological manifestations in three hospitals in Hong Kong (9 boys and 6 girls aged 1–13 years). All were unvaccinated or incompletely vaccinated. Fourteen (93.3%) were admitted for convulsion, including benign febrile seizure (n = 7), complex febrile seizure (n = 2), seizure with fever (n = 3), and recurrent breakthrough seizure (n = 2), and the remaining nonconvulsive patient developed encephalopathic state with impaired consciousness. None of the seven children with benign febrile seizure and six of eight children with other neurological manifestations had residual deficits at 9‐month follow‐up. SARS‐CoV‐2 RNA was undetectable in the cerebrospinal fluid (CSF) specimens of seven patients who underwent lumbar puncture. Spike‐and‐wave/sharp waves affecting the frontal lobes were detected in four of seven (57.1%) patients who underwent electroencephalogram. Children with Omicron‐related neurological manifestations had significantly higher blood levels of IL‐6 (p < 0.001) and CHI3L1 (p = 0.022) than healthy controls, and higher CSF levels of IL‐6 (p = 0.002) than children with non‐COVID‐19‐related febrile illnesses. Higher CSF‐to‐blood ratios of IL‐8 and CHI3L1 were associated with longer length of stay, whereas higher ratios of IL‐6 and IL‐8 were associated with higher blood tau level. The role of CSF:blood ratio of IL‐6, IL‐8, and CHI3L1 as prognostic markers for neuro–COVID should be further evaluated.

Publisher

Wiley

Subject

Infectious Diseases,Virology

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3