Association of seizures with COVID-19 infection in underage during the pandemic: A systematic review and meta-analysis.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a contagious infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that has caused worldwide transmission. The aim of this systematic review and meta-analysis was to investigate the morbidity and characteristics of seizures after SARS-CoV-2 infection in underage (≤18 y) and to provide valuable reference material for subsequent clinical treatment. METHODS: PubMed/MEDLINE, Cochrane, and EMBASE databases were searched up to 10th May 2023. We utilized the search strategy of medical subject headings combined with entry terms to search all related literatures. RESULTS: The meta-analysis was performed according to PRISMA reporting guidelines. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ). A total of 12 articles were selected, including 4153 subjects and 333 seizure-prone minor patients with COVID-19. The morbidity of seizures after SARS-CoV-2 infection in immature patients was approximately 8.2 (95 % CI, 4.7%-12.4 %). By subgroup analysis, we know that the morbidity of male, Americas, with fever and first occurrence of seizures were 4.2% (95 % CI, 0.4-10.5 %), 4.6 % (95 % CI, 0.4 %-11.7 %), 5.4 % (95 % CI, 2.6 %-9.1 %) and 3.7 % (95 % CI, 0.7 %-8.2 %), respectively. Generalized seizures are the main type of seizures (80.6 %). CONCLUSIONS: Seizures can be caused by SARS-CoV-2 infection in underage groups, with a pooled morbidity of 8.2% and a higher morbidity in females, in African regions, in febrile groups and during 2022-2023. In addition, generalized seizures being the predominant seizure type.

Association of cerebrospinal fluid advanced oxidation protein products levels with early brain injury and prognosis of aneurysmal subarachnoid hemorrhage: A preliminary prospective study.

OBJECTIVES: In this study, we investigated the time course in the cerebrospinal fluid (CSF) advanced oxidation protein products (AOPPs) levels in patients with aneurysmal subarachnoid hemorrhage (aSAH), and ascertained the relationship between the levels of AOPPs and early brain injury (EBI), hydrocephalus and prognosis of patients with aSAH. METHODS: We measured the CSF AOPPs levels in 50 patients with aSAH at 1-3 d, 4-6 d, 7-9 d, and 10-12 d after hemorrhage. The modified Fisher grades, Hunt-Hess grades, CSF IL-6 levels, peripheral blood count of white blood cells, cerebral edema scores and hydrocephalus were used to assess the severity of brain injury. Modified Rankin Scale (mRS) scores were used to assess the prognosis. Patients with mRS scores greater than 2 were considered to have a poor outcome. RESULTS: CSF AOPPs levels were significantly higher in patients with aSAH with poor prognosis, compared to patients with good prognosis and peaked in the early stage. Among patients with aSAH, the levels of CSF AOPPs on days 1-3 were significantly correlated with modified Fisher grades, Hunt-Hess grades, CSF IL-6 levels, peripheral blood count of white blood cells, and cerebral edema scores. Also, in patients with hydrocephalus, early CSF AOPPs levels were significantly elevated. Levels of CSF AOPPs in aSAH patients on days 1-3, 4-6, and 7-9 were independently associated with poor prognosis at the 90-day follow-up, and the optimal area under the curve (AUC) values for CSF AOPPs levels were found on days 1-3. CONCLUSIONS: AOPPs may serve as the potential biomarker to assess the severity of EBI and prognosis in patients with aSAH.