儿童SARS-CoV-2相关脑病变的临床特征:全国流行病学研究
Mariko Kasai1, Hiroshi Sakuma1, Yuichi Abe2
1Department of Brain and Neurosciences, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, Japan.
Journal of the neurological sciences
|January 10, 2024
概括
严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2) 可以导致儿童的急性脑病变. 这项研究发现,SARS-CoV-2相关的脑病变导致更糟糕的结果,严重的形式如AFCE和HSES的高发病率.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 儿科 儿科 儿科
背景情况:
- 严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2) 可以导致儿童的急性脑病变.
- 奥米克朗变种的出现增加了儿科COVID-19病例,需要对相关的神经并发症进行调查.
- 之前的研究已经描述了临床放射学发现,但流行病学变化需要进一步的文档.
研究的目的:
- 在Omicron亚变体 (BA.1/BA.2与BA.5) 主导期间调查SARS-CoV-2相关脑病变的流行病学差异.
- 为了比较SARS-CoV-2-相关和非SARS-CoV-2-相关儿童脑病变之间的临床和放射性特征.
主要方法:
- 在2022年6月至11月期间,对日本患有SARS-CoV-2相关脑病的儿童进行全国性调查.
- 在BA.5的主导时期的发现与以前的BA.1/BA.2数据的比较.
- 在SARS-CoV-2相关和非SARS-CoV-2相关脑病变之间对临床放射性综合征的比较分析.
主要成果:
- 在BA.5和早期期间之间没有发现显著的临床特征差异,尽管是常见的初始症状.
- 与非SARS-CoV-2-相关病例相比,SARS-CoV-2-相关脑病变患者的结果更差 (p=0.003).
- 13.6%的SARS-CoV-2相关脑病变病例是严重的 (AFCE/HSES),而27.2%的病例有不良结果 (后续/死亡). 92.2%的人没有接种疫苗.
结论:
- 在SARS-CoV-2相关脑病变中,急性 fulminant脑 (AFCE) 和出血性休克和脑病综合征 (HSES) 的高发病率有助于结果不佳.
- 这些发现凸显了SARS-CoV-2在儿科患者群体上的显著神经影响,特别是严重形式的脑病变.
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