Features of hospitalized pediatric patients with seizures and respiratory viruses: a comparison of SARS-CoV2, other corona viruses, and influenza

ABSTRACT

Objective: To compare features of hospitalized pediatric patients with seizures and respiratory viruses. Background: Neurological symptoms are reported in children with COVID-19, caused by SARS-CoV2. Limited data is available on neurological symptoms in other respiratory viruses, including influenza and other coronaviruses. Design/Methods: Retrospective data was extracted from EPIC on all children between 0-21 years old admitted to Children's Hospital of Atlanta from January 1, 2014 to June 1, 2021 for seizures and had positive PCR for SARS-CoV-2, other coronaviruses (Coronavirus NL63 and Coronavirus OC34) and influenza (A and B). Patient characteristics including age, race, sex, ethnicity, hospital length of stay, intensive care unit admission, intubation, chest x ray, MRI, and disposition were included. Comparison of patient characteristics between children with COVID-19 and the two other groups were conducted respectively. Results: A total of 487 pediatric patients were included 68 COVID-19, 232 influenza, and 187 with other coronaviruses (OC), with median age of 6.2 (interquartile range (IQR) [3.1,11.2]). COVID-19 patients had higher ICU admission rates (50% versus 31%, p = 0.008) but lower intubation rates than OC (19% versus 35%, p = 0.021). Stroke rates were higher in COVID-19 versus OC (6% versus 0.5%, p= 0.019). Initial white blood cell counts were lower in the COVID-19 (median 7.32[6.05, 11.07]) than OC (median 10.66[ 7.61, 14.26];p = 0.001). The rate of abnormal MRI was lower among COVID-19 patients, compared to OC patients (57% versus 82%) with a medium to large effect size (standard mean difference) of 0.55. However, no differences were observed between COVID-19 and influenza cohorts. Conclusions: Differences in patients with COVID-19 versus other coronaviruses were observed, whereas no differences were observed in COVID-19 versus influenza patients. Vigilance should be undertaken in treatment of children presenting with all respiratory illnesses.