The Impact of Omicron Wave on Pediatric Febrile Seizure
Jaehyung Joung1, Heewon Yang1, Yoo Jin Choi1
1Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea.
Insights
The omicron variant of COVID-19 led to more pediatric febrile seizures in South Korea. Children with COVID-19 and febrile seizures during the omicron period were older and had higher fevers.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Epidemiology
Background:
- The Omicron variant of coronavirus disease 2019 (COVID-19) was highly infectious, causing a surge in cases.
- Increased COVID-19 cases led to a rise in hospitalizations among pediatric patients.
- This study focuses on febrile seizures in children during the Omicron variant surge.
Purpose of the Study:
- To evaluate the frequency of febrile seizures associated with the COVID-19 Omicron variant in children.
- To analyze the clinical characteristics of these febrile seizures.
- To compare febrile seizure characteristics between pre-Omicron and Omicron periods, and between COVID-19 positive and negative children during the Omicron period.
Main Methods:
- Retrospective review of medical records of children under 18 with febrile seizures from February 2020 to April 2022.
- Study period divided into pre-Omicron (Feb 2020–Dec 2021) and Omicron (Jan 2022–Apr 2022) phases.
- Comparison of clinical characteristics between periods and between COVID-19 positive and negative groups during the Omicron period.
Main Results:
- The Omicron period saw a higher incidence of febrile seizures per month (24.3) compared to the pre-Omicron period (9.2).
- Children in the Omicron period were significantly older (mean age 28.0 months vs. 22.0 months) and had higher rates of COVID-19 positivity (62.9% vs. 0.5%).
- COVID-19 positive children during the Omicron period had higher mean age (33.0 vs. 23.0 months) and peak body temperature (39.1°C vs. 38.6°C) compared to COVID-19 negative children.
Conclusions:
- The frequency of COVID-19-associated febrile seizures increased during the Omicron variant periods.
- Children with COVID-19 and febrile seizures during the Omicron period were older and presented with higher fever.
- A trend towards longer seizure duration, multiple episodes, and complex febrile seizures was observed in COVID-19 positive children.
Background:
The coronavirus disease 2019 (COVID-19) omicron (B.1.1.529) variant reduced the risk of severe disease compared with the original strain and other variants, but it appeared to be highly infectious, which resulted in an exponential increase in confirmed cases in South Korea. As the number of confirmed cases increased, so did the number of pediatric patients' hospitalization. This study aims to evaluate the frequency and clinical features of febrile seizure associated with the COVID-19 omicron variant in children.
Methods:
We retrospectively reviewed the medical records of children aged under 18 years with febrile seizure who were tested for COVID-19 from February 2020 to April 2022 at Ajou University Hospital, South Korea. Based on the dominant variants, we divided the period into the pre-omicron (from February 2020 to December 2021) and omicron periods (from January 2022 to April 2022) and compared the clinical characteristics between the two. Also, we compared the clinical characteristics of febrile seizure between COVID-19 positive and negative group during the omicron period.
Results:
Among the 308 children, 211 patients (9.2 patients/months) and 97 patients (24.3 patients/months) were grouped into pre-omicron and omicron periods, respectively. Compared with the pre-omicron period, patients in the omicron period showed significantly higher mean age (pre-omicron vs. omicron, 22.0 vs. 28.0 months; P = 0.004) and COVID-19 positive results (pre-omicron vs. omicron, 0.5% vs. 62.9%; P < 0.001). As the COVID-19 confirmed cases in the omicron period increased, the number of COVID-19 associated febrile seizure also increased. In the omicron period, 61 children were confirmed to be positive for COVID-19, and COVID-19 positive group showed statistically significant higher mean age (positive vs. negative, 33.0 vs. 23.0 months; P = 0.003) and peak body temperature than the negative group (positive vs. negative, 39.1°C vs. 38.6°C; P = 0.030). Despite the lack of significance, COVID-19 positive group showed longer seizure time, multiple seizure episodes, and higher prevalence of complex febrile seizure.
Conclusion:
The frequency of COVID-19 associated febrile seizure increased in the omicron periods. In addition, in this period, children with febrile seizure diagnosed with COVID-19 had a higher mean age and higher peak body temperature.
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