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Delirium in Children Hospitalized with Acute COVID-19 or MIS-C: Secondary Analysis of the 2020-2021 Global Consortium

Neelima K Marupudi1, Diana Paola Escobar Serna2,3, Leslie Dervan4

  • 1Department of Child Health, University of Arizona, Banner Children's Hospital at Desert, 1400 S. Dobson Rd., Mesa, AZ, 85202, USA. Neelima.Marupudi@Bannerhealth.com.

Neurocritical Care
|April 6, 2026
PubMed

Insights

Pediatric delirium in hospitalized children with COVID-19 or MIS-C was linked to inflammation and severe neurological issues. Early screening for delirium is crucial for better outcomes in these children.

Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Neurology

Background:

  • Pediatric delirium is a significant concern in hospitalized children.
  • Understanding delirium's associations in COVID-19 and MIS-C is crucial.

Purpose of the Study:

  • To describe pediatric delirium.
  • To investigate its association with inflammatory markers, neurodiagnostic findings, and clinical severity in children with acute COVID-19 or MIS-C.

Main Methods:

  • Secondary analysis of a multicenter, prospective observational cohort study.
  • Included hospitalized children (<18 years) with confirmed acute COVID-19 or MIS-C.
  • Data collected from January 2020 to July 2021 across 46 hospitals globally.

Main Results:

  • Delirium occurred in 1.8% of 3211 patients, more frequently in MIS-C (3.6%) than COVID-19 (1.5%).
  • Delirious children had higher inflammatory markers, severe neurological manifestations, and abnormal EEG findings.
  • Delirium was associated with longer hospital stays, higher mortality, and worse functional outcomes (PCPC, FSS).

Conclusions:

  • Pediatric delirium in SARS-CoV-2-related illness correlates with systemic inflammation, neurological injury, and adverse clinical outcomes.
  • Routine delirium screening and intervention are vital for children hospitalized with SARS-CoV-2 infections and other inflammatory conditions.
Abstract

Keywords:
BiomarkersCOVID-19DeliriumHospitalized childInflammationNeuroimaging

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