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Specific convulsions and brain damage in children hospitalized for Omicron BA.5 infection: an observational study
Yuan-Yuan Pei1, Hong-Li Wang2, Gen-Quan Yin3
1Clinical Data Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China.
Background:
SARS-CoV-2 continues to mutate over time, and reports on children infected with Omicron BA.5 are limited. We aimed to analyze the specific symptoms of Omicron-infected children and to improve patient care.
Methods:
We selected 315 consecutively hospitalized children with Omicron BA.5 and 16,744 non-Omicron-infected febrile children visiting the fever clinic at our hospital between December 8 and 30, 2022. Specific convulsions and body temperatures were compared between the two cohorts. We analyzed potential associations between convulsions and vaccination, and additionally evaluated the brain damage among severe Omicron-infected children.
Results:
Convulsion rates (97.5% vs. 4.3%, < 0.001) and frequencies (median: 2.0 vs. 1.6, < 0.001) significantly differed between Omicron-infected and non-Omicron-infected febrile children. The body temperatures of Omicron-infected children were significantly higher during convulsions than when they were not convulsing and those of non-Omicron-infected febrile children during convulsions (median: 39.5 vs. 38.2 and 38.6 °C, both < 0.001). In the three Omicron-subgroups, the temperature during convulsions was proportional to the percentage of patients and significantly differed ( < 0.001), while not in the three non-Omicron-subgroups = 0.244). The convulsion frequency was lower in the 55 vaccinated children compared to the 260 non-vaccinated children (average: 1.8 vs. 2.1, < 0.001). The vaccination dose and convulsion frequency in Omicron-infected children were significantly correlated ( < 0.001). Fifteen of the 112 severe Omicron cases had brain damage.
Conclusions:
Omicron-infected children experience higher body temperatures and frequencies during convulsions than those of non-Omicron-infected febrile children. We additionally found evidence of brain damage caused by infection with omicron BA.5. Vaccination and prompt fever reduction may relieve symptoms.
Insights
Children infected with Omicron BA.5 experienced more frequent and severe febrile convulsions with higher temperatures. Vaccination may reduce convulsion frequency, and prompt fever reduction is recommended for symptom relief in pediatric Omicron BA.5 cases.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Neurology
Background:
- SARS-CoV-2 Omicron BA.5 variant poses risks to children, with limited data on its specific clinical manifestations.
- Understanding Omicron BA.5 symptoms in children is crucial for improving patient care and management.
Purpose of the Study:
- To analyze the specific symptoms of SARS-CoV-2 Omicron BA.5 infection in hospitalized children.
- To compare clinical features, particularly febrile convulsions and body temperature, between Omicron BA.5 infected and non-Omicron infected children.
- To investigate the association between vaccination status and convulsion frequency, and to assess the occurrence of brain damage in severe cases.
Main Methods:
- A retrospective cohort study comparing 315 hospitalized children with Omicron BA.5 and 16,744 non-Omicron febrile children.
- Analysis of convulsion rates, frequencies, and body temperatures during febrile episodes.
- Evaluation of the correlation between vaccination status, vaccination dose, and convulsion frequency.
- Assessment of brain damage in severe Omicron BA.5 cases.
Main Results:
- Omicron BA.5 infected children exhibited significantly higher convulsion rates (97.5% vs. 4.3%) and frequencies (median 2.0 vs. 1.6) compared to non-Omicron infected children.
- Body temperatures during convulsions were significantly higher in Omicron BA.5 infected children (median 39.5°C vs. 38.2°C and 38.6°C).
- Convulsion frequency was lower in vaccinated children (1.8) versus unvaccinated (2.1), with a significant correlation between vaccination dose and frequency. Fifteen of 112 severe cases showed brain damage.
Conclusions:
- SARS-CoV-2 Omicron BA.5 infection in children is associated with increased frequency and severity of febrile convulsions and higher temperatures.
- Vaccination appears to reduce convulsion frequency in pediatric Omicron BA.5 cases.
- Evidence of brain damage in severe Omicron BA.5 infections highlights the need for prompt fever management and potential prophylactic measures.
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