Convulsions in children with COVID-19 during the Omicron wave
Jonas F Ludvigsson1,2,3
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Insights
Convulsions in children may signal the Omicron variant of COVID-19. This study details unexpected cases of seizures in pediatric patients during the Omicron surge, highlighting a potential new symptom.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- While most pediatric COVID-19 cases are mild, the Omicron variant's specific neurological manifestations remain under-documented.
- Understanding variant-specific symptoms is crucial for timely diagnosis and management in children.
Observation:
- Four pediatric patients presented with convulsions during a one-week period in January 2022, coinciding with Omicron being the dominant COVID-19 strain in Sweden (>98%).
- Three patients tested positive for SARS-CoV-2; one presented with clinical symptoms consistent with COVID-19.
- Case studies involved children aged 3 months, 21 months, and 14 years, with varying seizure durations and associated symptoms like fever and upper respiratory issues.
Findings:
- Two young children (3 and 21 months) tested positive for SARS-CoV-2 and experienced prolonged or repeated convulsions.
- A 14-year-old, testing negative but with relevant symptoms and exposure, also had a convulsion.
- None of the children had prior histories of epilepsy or febrile seizures, suggesting a potential link to acute COVID-19 infection.
Implications:
- Pediatric convulsions, particularly during periods of high Omicron prevalence, warrant consideration for COVID-19 testing.
- This observation suggests that seizures may be an unexpected neurological symptom associated with the Omicron variant in children.
- Further research is needed to confirm the causal relationship and understand the pathophysiology of Omicron-related seizures in pediatric populations.
Aim:
Most children with COVID-19 have mild symptoms, but data on the Omicron variant are rare. This paper describes unexpected cases with convulsions during 1 week in January 2022.
Methods:
Four children with COVID-19 were admitted with convulsions to the paediatric department in Örebro, Sweden, when Omicron accounted for more than 98% of the country's COVID-19 cases. Three children tested positive for the virus, and one had clinical COVID-19. I was able to contact the parents of three boys, who gave consent for these case studies.
Results:
Two boys aged 3 and 21 months tested positive for the virus and a 14-year-old boy tested negative, but had a cold and family members who had tested positive. The teenager had a history of urinary tract infections, but the younger boys had no earlier comorbidities. None had a history of epilepsy or febrile convulsions. The younger children had a fever and the teenager had upper respiratory symptoms. The 3-month-old child had repeated convulsions for several hours, the 21-month-old had continuous convulsions for 15-20 min, and the teenager had a convulsion for 30-60 s, followed by uncharacteristic aggression.
Conclusion:
Convulsions may be a sign of the Omicron variant in children with COVID-19.
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