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Human parechovirus meningitis and gross-motor neurodevelopment in young children
Ted M T van Hinsbergh1, Stephanie C M de Crom2, Robert Lindeboom3
1Department of Pediatrics, Elisabeth-Tweesteden Hospital, Hilvarenbeekseweg 60, 5022 LC, Tilburg, the Netherlands. t.vanhinsbergh@etz.nl.
Insights
Human parechovirus meningitis may impact young children's gross-motor development, showing more delays than other infection groups. Early screening for developmental delays is crucial for intervention.
Area of Science:
- Pediatrics
- Neurodevelopmental Pediatrics
- Infectious Diseases
Background:
- Human parechovirus is an emerging cause of meningitis in children.
- There is a need to understand the neurodevelopmental outcomes for infants affected by human parechovirus meningitis.
Purpose of the Study:
- To prospectively assess the impact of human parechovirus meningitis on gross-motor neurodevelopment in young children.
- To compare motor function in children with human parechovirus meningitis to those with other parechovirus infections and a reference group.
Main Methods:
- A multicenter prospective cohort study involving 38 children under 10 months of age.
- Gross-motor function assessed using the Alberta Infant Motor Scale.
- Children categorized into: human parechovirus meningitis (CSF positive), other parechovirus infection (non-CSF positive), and no pathogen identified.
Main Results:
- Children with human parechovirus meningitis exhibited a higher frequency of suspect gross-motor function delay (mean Z-score -1.69) compared to other groups.
- The difference in motor delay between the meningitis group and other groups was not statistically significant.
- The reference group did not show suspect gross-motor function delay (mean Z-score -0.96).
Conclusions:
- Six months post-infection, children with human parechovirus meningitis showed a trend towards more suspect gross-motor delays.
- Larger longitudinal studies with longer follow-up are required to confirm the long-term neurodevelopmental impact.
- Screening young children for developmental delays is important for timely intervention and maximizing developmental potential.
Abstract:
This multicenter prospective cohort study describes the impact of human parechovirus meningitis on gross-motor neurodevelopment of young children. Gross-motor function was measured using Alberta Infant Motor Scale. Of a total of 38 eligible children < 10 months of age at onset, nine cases had clinical evidence of meningitis and polymerase chain reaction positive for human parechovirus in cerebrospinal fluid; 11 had no meningitis and polymerase chain reaction positive for human parechovirus in nasopharyngeal aspirate, blood, urine, or feces; and in 18, no pathogen was identified (reference group).The children with human parechovirus meningitis showed more frequent albeit not statistically significant suspect gross-motor function delay (mean Z-score (standard deviation) - 1.69 (1.05)) than children with human parechovirus infection-elsewhere (- 1.38 (1.51)). The reference group did not fall in the range of suspect gross-motor function delay (- 0.96 (1.07)). Adjustment for age at onset and maternal education did not alter the results.Conclusion: Six months after infection, children with human parechovirus meningitis showed more frequent albeit not statistically significant suspect gross-motor function delay compared to the population norm and other two groups. Longitudinal studies in larger samples and longer follow-up periods are needed to confirm the impact and persistence of human parechovirus meningitis on neurodevelopment in young children. What is Known: • Human parechovirus is progressively becoming a major viral cause of meningitis in children. • There is keen interest in the development of affected infants with human parechovirus meningitis. What is New: • This study describes prospectively gross-motor functional delay in children with both clinical evidence of meningitis and polymerase chain reaction positive for human parechovirus in cerebrospinal fluid. • It shows the importance of screening young children for developmental delay in order to refer those with delay for early intervention to maximize their developmental potential.
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