Document Type : original article
Authors
- Javad Akhondian 1
- Elahe Derakhshan-Nezhad 2
- Matin Dowlat Abadi 2
- Sahel Yazdanpanahi 2
- Niloofar Nikpour 2
- Zahra Chaichy 3
1 Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Department of Pediatric Diseases, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract
Background: Considering the increased incidence of Febrile Seizures (FS) after omicron emergence, this study aimed to evaluate the frequency of FS in COVID-19 children, under 14 years of age, in Akbar Children's Hospital in Mashhad, Iran. This study also compared the characteristics of FS children with and without COVID-19.
Methods: All patients under 14 years of age, who were hospitalized and diagnosed with COVID-19 in Akbar hospital, from March 2020 to 2022, were included in this study. The incidence of FS was determined in this group. Also, all patients who were diagnosed with FS, tested negative for COVID-19, and had no underlying diseases were included in the control group. Hospital Information System (HIS) was used to extract the desired information.
Result: Out of 220 COVID-19 children studied, eight (3.60%) had febrile seizures, of whom 50% were male, and 50% were female, and their average age was 13.9±6.96 months. Also, 62.5% had simple FS, and 37.5% had complex FS. Among them, 12.5% had leukopenia, 12.5% had lymphopenia, 62.5% had pneumonia symptoms, 50% had fever, 37.5% had tachycardia, and 25% had tachycardia symptoms. The average age of COVID-19 patients with FS was significantly lower than that of the patients with either COVID-19 or FS (p=0.01). Complex FS was significantly more prevalent in patients with COVID-19 than in patients without COVID-19 (p=0.01).
Conclusion: The frequency of COVID-19-associated FS increased during the omicron period. There are several potential mechanisms through which febrile seizures could occur. Considering that there are still many unknowns in this field, it is necessary to conduct more studies.
Keywords
- Mahajan N, Singla M, Singh B, Sajja V, Bansal P, Paul B, et al. 2019-NCoV: What every neurologist should know?. Annals of Indian Academy of Neurology. 2020 Apr 1;23(Suppl 1):S28-32.
- Tsivgoulis G, Palaiodimou L, Katsanos AH, Caso V, Köhrmann M, Molina C, et al. <? covid19?> Neurological manifestations and implications of COVID-19 pandemic. Therapeutic advances in neurological disorders. 2020 Jun;13:1756286420932036.
- Bildik O, Dundar NO, Basarir G, Ersen A, Yilmaz SB, Kusgöz F, et al. Coronavirus disease 2019-associated neurological manifestations in children: a large single-center experience with rare cases. Pediatric Neurology. 2023 Aug 1;145:148-53.
- Elshebawy H, Ezzeldin MY, Elzamarany EH. Characteristics of COVID and post COVID polyneuropathies in adults and pediatrics: an Egyptian sample. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 2021 Dec;57:1-7.
- Vohora D, Jain S, Tripathi M, Potschka H. COVID‐19 and seizures: is there a link?. Epilepsia. 2020 Sep;61(9):1840-53.
- Vargas G, Geraldo LH, Salomão NG, Paes MV, Lima FR, Gomes FC. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and glial cells: Insights and perspectives. Brain, behavior, & immunity-health. 2020 Aug 1;7:100127.
- Nalleballe K, Onteddu SR, Sharma R, Dandu V, Brown A, Jasti M, et al. Spectrum of neuropsychiatric manifestations in COVID-19. Brain, behavior, and immunity. 2020 Aug 1;88:71-4.
- Morgello S. Coronaviruses and the central nervous system. Journal of neurovirology. 2020 Aug;26(4):459-73.
- Hongo H, Nishiyama M, Ueda T, Ishida Y, Kasai M, Tanaka R, et al. Comparison of neurological manifestation in children with and without coronavirus 2019 experiencing seizures with fever. Epilepsy & Behavior Reports. 2023 Jan 1;24:100625.
- Ousseiran ZH, Fares Y, Chamoun WT. Neurological manifestations of COVID-19: a systematic review and detailed comprehension. International Journal of Neuroscience. 2023 Jul 3;133(7):754-69.
- Misra S, Kolappa K, Prasad M, Radhakrishnan D, Thakur KT, Solomon T, et al. Frequency of neurologic manifestations in COVID-19: a systematic review and meta-analysis. Neurology. 2021 Dec 7;97(23):e2269-81.
- Mahdizade Ari M, Mohamadi MH, Shadab Mehr N, Abbasimoghaddam S, Shekartabar A, Heidary M, et al. Neurological manifestations in patients with COVID‐19: A systematic review and meta‐analysis. Journal of Clinical Laboratory Analysis. 2022 May;36(5):e24403.
- Antoon JW, Hall M, Howard LM, Herndon A, Freundlich KL, Grijalva CG, et al. COVID-19 and acute neurologic complications in children. Pediatrics. 2022 Nov 1;150(5):e2022058167.
- Yu L, Wang C, Li X, Wang X, Kang Y, Ma X, et al. Clinical characteristics of abruptly increased paediatric patients with Omicron BF. 7 or BA. 5.2 in Beijing. Virology Journal. 2023 Sep 8;20(1):209.
- Liu HF, Lu R, Yang J, Xiang M, Ban D, Yang JW, et al. Evaluation of febrile seizures in children infected with SARS-CoV-2 Omicron variant in Yunnan, China: a multi-center, retrospective observational study. Frontiers in Pediatrics. 2023 Nov 13;11:1223521.
- Kim AY, Na JH, Kang HY, Lee H, Lee YM. Effects of the coronavirus disease outbreak on the development of neurological disorders in children: A comparison of the incidence of febrile seizure and epilepsy using an interrupted time-series approach. Journal of Infection and Public Health. 2024 Jan 1;17(1):102-8.
- Joung J, Yang H, Choi YJ, Lee J, Ko Y. The impact of Omicron wave on pediatric febrile seizure. Journal of Korean Medical Science. 2023 Jan 16;38(3).
- Hanlon SM, Sim D, Schneider JG, Yang Z, Thompson SM. The association between COVID-19 and febrile seizure: A retrospective case-control study. Pediatric Emergency Care. 2023 May 1;39(5):360-3.
- Kim JM, Park EG, Lee JY, Kim YH, Kim Y, Kim HS, et al. Characteristics of febrile seizures with SARS-CoV-2 infection in the Omicron era. Translational Pediatrics. 2023 May 5;12(5):807.
- Salleh H, Soon IS, Chong VH. Frequency and risk factors for febrile seizures during COVID-19 pandemic waves: an observational study. European Journal of Pediatrics. 2023 Jul;182(7):3337-45.
- Cross JH. Fever and fever‐related epilepsies. Epilepsia. 2012 Sep;53:3-8.
- Tang CM, Kuo CY, Yen CW, Lin JJ, Hsieh YC, Hsia SH, et al. Predicting factors for acute encephalopathy in febrile seizure children with SARS-CoV-2 omicron variant: a retrospective study. BMC pediatrics. 2024 Mar 25;24(1):211.
- Nikbakht F, Mohammadkhanizadeh A, Mohammadi E. How does the COVID-19 cause seizure and epilepsy in patients? The potential mechanisms. Multiple sclerosis and related disorders. 2020 Nov 1;46:102535.
- Laino D, Mencaroni E, Esposito S. Management of pediatric febrile seizures. International journal of environmental research and public health. 2018 Oct;15(10):2232.
- Cadet K, Boegner J, Ceneviva GD, Thomas NJ, Krawiec C. Evaluation of febrile seizure diagnoses associated with COVID-19. Journal of child neurology. 2022 Apr;37(5):410-5.
- Han MJ, Heo JH, Hwang JS, Jang YT, Lee M, Kim SJ. Incidence of febrile seizures in children with COVID-19. Journal of Clinical Medicine. 2023 Jan 30;12(3):1076.
- Seo MJ, Yum MS, Park JS. Comparison of febrile seizures in children with or without coronavirus disease‐2019: A single‐center observational study. Pediatrics International. 2023 Jan;65(1):e15461.