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Frequency and risk factors for febrile seizures during COVID-19 pandemic waves: an observational study
Hafizah Salleh1, Ing Shian Soon2, Vui Heng Chong3
1Department of Paediatrics, RIPAS Hospital, Bandar Seri Begawan, BA1710, Brunei Darussalam. hafizahsall@gmail.com.
Insights
Febrile seizures (FS) in children with COVID-19 occurred primarily during the Omicron variant wave. Younger age, family history, and fewer symptoms were linked to increased FS risk.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Febrile seizures (FS) are common in children, often triggered by viral illnesses.
- The association between COVID-19 and FS in pediatric populations requires further investigation.
- Understanding FS prevalence and risk factors in the context of different SARS-CoV-2 variants is crucial.
Purpose of the Study:
- To determine the prevalence of febrile seizures (FS) in pediatric COVID-19 patients in Brunei Darussalam.
- To identify factors associated with FS in children diagnosed with COVID-19.
- To analyze FS occurrence across different SARS-CoV-2 variants (original, Delta, Omicron).
Main Methods:
- Retrospective analysis of pediatric patients (<12 years) admitted with COVID-19 during three waves.
- Data extracted from a prospective database and national electronic health records.
- Comparison of patients with and without FS to identify significant risk factors using univariate and multivariate analyses.
Main Results:
- Febrile seizures (FS) were exclusively observed during the third wave (Omicron variant), with a prevalence of 13% among pediatric COVID-19 patients in this wave (4.5% overall).
- The majority of FS cases (83%) occurred in the typical age group (6 months to <6 years).
- Significant risk factors for FS included typical age group, family history of FS, and fewer reported symptoms (≤3) on presentation.
Conclusions:
- Febrile seizures (FS) in pediatric COVID-19 patients in Brunei Darussalam were strongly associated with the Omicron variant.
- Key risk factors for FS include younger age, a family history of seizures, and a lower number of presenting symptoms.
- The findings highlight a specific association between Omicron infections and FS in children, warranting further research.
Abstract:
Febrile seizures (FS) are well-known manifestations of viral illnesses. The purpose of this study is to assess the prevalence and factors associated with FS among pediatric patients with COVID-19 admitted to the National Isolation Centre in Brunei Darussalam. All pediatric patients (< 12 years) during the first (n = 12), second (n = 418), and third (n = 219) waves were included in the study. In Brunei, the first, second, and third waves were caused by the original SARS-CoV-2, Delta, and Omicron variants, respectively. Data was extracted from a prospective database and the national electronic health record system. Patients with and without FS were compared to identify any significant risk factors. FS were only encountered in the third wave (n = 29, 13%) giving an overall prevalence of 4.5%; 24 (83%) occurring in the typical age group for FS (≥ 6 months to < 6 years). Five cases (17%) occurred in children 6 years and older. Comparing patients in the third wave, univariate analyses showed typical age group, previous history of FS, family history of FS, higher temperature (> 38.6 °C), and fewer symptoms on presentation (3 or less) were associated with FS. On multivariate analyses, typical age group, family history of FS, and fewer reported symptoms remained significant (all p < 0.05). Conclusions: The overall prevalence of FS in COVID-19 patients is comparable to rates reported. However, in Brunei Darussalam, FS only occurred in the third wave that has been associated with Omicron variant. Younger age group, family history of FS, and fewer symptoms on presentation are correlated with risk of FS. What is Known: • Viral infections are the most common cause of FS in children. •Young age and a personal and family history of FS are correlated with the risk of FS. What is New: • There were high rates of FS (13%) among pediatric patients admitted with COVID-19 due to the Omicron variant but not with the original and Delta variants. • FS with COVID-19 were correlated with reporting fewer symptoms on presentation.
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