RESUMEN
A big infectious wave overwhelmingly spread from February 2022 in South Korea after the COVID-19 outbreak was managed. Therefore, we analysed electroencephalogram (EEG) findings and serologic inflammatory markers in pediatric patients with COVID-19 by retrospectively reviewing medical records of 41 patients who visited Gyeongsang National University Changwon Hospital from March to May 2022 and were diagnosed with COVID-19; all serologic tests were performed within 24 hours after presenting with fever or seizure. The median patient age and average number of hospitalisation days were 3.6 (0.08–14.00) years and 3.71 (1.0–7.0) days, respectively. Interleukin-6 (IL-6) were elevated above the normal range in all patients (median value, 43.18 [7.0–190.0] pg/ml) and were higher among patients with seizures. Among 41 patients, 17 (41.5%) with a mean age of 5.4 years had higher complaints of seizures. Three patients had prolonged seizures for > 30 minutes and received intravenous lorazepam injections and eight had a complex type of febrile convulsion. Nine patients underwent EEG, and five showed abnormal findings in the initial EEG. In the linear regression model, serum IL-6 and blood lymphocyte counts were correlated with prolonged seizure duration. These findings underscore that several immune cascade-related serologic markers were elevated in children with COVID-19-related febrile seizures. We may assume that COVID-19 presents similarities and differences in the mechanisms that provoke seizures and fever in children.
Asunto(s)
Fiebre , Convulsiones Febriles , COVID-19 , ConvulsionesRESUMEN
Background Data on SARS-CoV-2 transmission from a pediatric index patient to others at the school setting are limited. Epidemiologic data on pediatric COVID-19 cases after school opening is warranted. Methods We analyzed data of the pediatric patients with COVID-19 collected from the press release of the Korea Centers for Disease Control and Prevention. Information on the school opening delay and re-opening policies were achieved from the press release from Korean Ministry of Education. Findings The school openings were delayed three times in March 2020. Online classes started from April 9, and off-line classes started from May 20 to June 8 at four steps in different grades of students. There was no sudden increase in pediatric cases after the school opening, and the proportion of pediatric cases remained around 7.0% to 7.1%. As of July 11, 45 children from 40 schools and kindergartens were diagnosed with COVID-19 after off-line classes started. More than 11,000 students and staff were tested; only one additional student was found to be infected in the same classroom. Among those 45, 32 (71.1%) patients had available information for the source of infection. Twenty-five (25/45, 55.6%) were infected by the family members. The proportions of pediatric patients without information on infection sources were higher in older age group (middle and high school students) than in younger age group (kindergarten and elementary school students) (47.6% vs 12.5%, p=0.010). In the younger age group, 79.1% of children were infected by family members, while only 28.6% of adolescents in the older age group were infected by family members (p<0.001). Interpretation Korea had a successful transition from school closure to re-opening with online and off-line classes. Although partial, off-line school opening did not cause significant school-related outbreak among pediatric population although young children and adolescents may have different epidemiologic features.