Related Experiment Video
Updated: Jun 29, 2025
A Murine Model of Dengue Virus-induced Acute Viral Encephalitis-like Disease
Published on: April 28, 2019
Predicting factors for acute encephalopathy in febrile seizure children with SARS-CoV-2 omicron variant: a
Ching-Min Tang1,2, Cheng-Yen Kuo1, Chen-Wei Yen3,4
1Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Kwei-Shan, 5 Fu-Shin Street, Taoyuan, 333, Taiwan.
Insights
SARS-CoV-2 Omicron infections in children can cause febrile seizures and acute encephalopathy. Key predictors include prolonged fever, seizures beyond day one, bradycardia, hyperglycemia, and metabolic acidosis, indicating potential encephalitis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- The SARS-CoV-2 Omicron variant posed a significant threat to children, often presenting with febrile seizures.
- Understanding predictors of acute encephalopathy in pediatric COVID-19 cases is crucial.
Purpose of the Study:
- To investigate factors predicting acute encephalopathy in children with SARS-CoV-2 Omicron variant-associated febrile seizures.
- To identify clinical and laboratory characteristics differentiating acute encephalopathy from other causes of febrile seizures in pediatric COVID-19 patients.
Main Methods:
- Retrospective analysis of pediatric emergency department data from Chang Gung Memorial Hospital, Taiwan (April-July 2022).
- Focused on children with COVID-19 and febrile seizures, collecting demographic, clinical, and laboratory data.
- Comparative analysis between patients with acute encephalopathy and those with other causes of febrile seizures.
Main Results:
- Out of 116 SARS-CoV-2 positive children with febrile seizures, 14 (12%) developed acute encephalopathy.
- Acute encephalopathy patients were older, had longer fever duration, and more frequent cluster seizures and status epilepticus.
- Distinctive findings included bradycardia, hypotension, hyperglycemia, and metabolic acidosis in the encephalopathy group.
Conclusions:
- Seizures beyond the first day of fever, bradycardia, clustered seizures, status epilepticus, hyperglycemia, and metabolic acidosis are warning signs for acute encephalitis/encephalopathy in pediatric COVID-19.
- High body temperature and inflammatory markers (leukocytosis, C-reactive protein) were not associated with poor outcomes.
Background:
SARS-CoV-2 posed a threat to children during the early phase of Omicron wave because many patients presented with febrile seizures. The study aimed to investigate predicting factors for acute encephalopathy of children infected by SARS-CoV-2 Omicron variant presenting with febrile seizures.
Methods:
The retrospective study analyzed data from pediatric patients who visited the emergency department of Chang Gung Memorial Hospital in Taiwan between April and July 2022. We specifically focused on children with COVID-19 who presented with febrile seizures, collecting demographic, clinical, and laboratory data at the pediatric emergency department, as well as final discharge diagnoses. Subsequently, we conducted a comparative analysis of the clinical and laboratory characteristics between patients diagnosed with acute encephalopathy and those with other causes of febrile seizures.
Results:
Overall, 10,878 children were included, of which 260 patients presented with febrile seizures. Among them, 116 individuals tested positive for SARS-CoV-2 and of them, 14 subsequently developed acute encephalopathy (12%). Those with acute encephalopathy displayed distinctive features, including older age (5.1 vs. 2.6 years old), longer fever duration preceding the first seizure (1.6 vs. 0.9 days), cluster seizure (50% vs. 16.7%), status epilepticus (50% vs. 13.7%) and occurrences of bradycardia (26.8% vs. 0%) and hypotension (14.3% vs. 0%) in the encephalopathy group. Besides, the laboratory findings in the encephalopathy group are characterized by hyperglycemia (mean (95% CI) 146 mg/dL (95% CI 109-157) vs. 108 mg/dL (95% CI 103-114) and metabolic acidosis (mean (95% CI) pH 7.29(95% CI 7.22-7.36) vs. 7.39 (95%CI 7.37-7.41)).
Conclusions:
In pediatric patients with COVID-19-related febrile seizures, the occurrence of seizures beyond the first day of fever, bradycardia, clustered seizures, status epilepticus, hyperglycemia, and metabolic acidosis should raise concerns about acute encephalitis/encephalopathy. However, the highest body temperature and the severity of leukocytosis or C-reactive protein levels were not associated with poor outcomes.
More Related Videos
03:53Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
10:22Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
Published on: December 6, 2016
