The Pediatric infectious disease journal · 2025
Worse Neurologic Outcomes Observed in Pediatric COVID-19-associated Encephalopathy Than in Influenza-associated Encephalopathy.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Takei Haruka, Furuichi Mihoko, Kikuchi Kenjiro, Ogimi Chikara, Takeuchi Tomoya, Furuichi Munehiro, Otsubo Yuto, Motobayashi Mitsuo, Yamamoto Shota, Futatsugi Ryohei, Suganuma Eisuke
Аннотация
BACKGROUND: Pediatric coronavirus disease (COVID-19)-associated encephalopathy can lead to severe neurologic complications. However, data comparing it with other infectious encephalopathies are limited. This study aimed to compare the clinical characteristics of COVID-19-associated encephalopathy with those of influenza-associated encephalopathy, which serves as a representative model of severe infectious encephalopathy in Japan. Additionally, we assessed the factors associated with a poor prognosis.
METHODS: We conducted a retrospective cohort study of patients with COVID-19- and influenza-associated encephalopathy admitted to 7 children's hospitals in Japan between January 2017 and December 2023. Clinical characteristics were compared using the Mann-Whitney U test and Fisher exact test. Additionally, logistic regression analysis was performed to identify factors associated with a pediatric cerebral performance category score ≥4 at discharge.
RESULTS: A total of 89 patients were included: 29 in the COVID-19 group and 60 in the influenza group. Demographics and initial clinical characteristics were similar between groups. However, a significantly higher proportion of patients in the COVID-19 group had a pediatric cerebral performance category score ≥4 at discharge (37.9% vs. 16.7%, P = 0.04). In each of the 3 separate multivariable models, COVID-19, the presence of underlying neurologic conditions and shorter time from onset to encephalopathy diagnosis were independently associated with poor prognosis.
CONCLUSIONS: The clinical characteristics of the 2 groups were similar; however, patients with COVID-19-associated encephalopathy showed worse discharge neurologic outcomes, warranting cautious interpretation. Enhancing public awareness of the severe outcomes and conducting further research is essential for better understanding its pathogenesis and treatment.
METHODS: We conducted a retrospective cohort study of patients with COVID-19- and influenza-associated encephalopathy admitted to 7 children's hospitals in Japan between January 2017 and December 2023. Clinical characteristics were compared using the Mann-Whitney U test and Fisher exact test. Additionally, logistic regression analysis was performed to identify factors associated with a pediatric cerebral performance category score ≥4 at discharge.
RESULTS: A total of 89 patients were included: 29 in the COVID-19 group and 60 in the influenza group. Demographics and initial clinical characteristics were similar between groups. However, a significantly higher proportion of patients in the COVID-19 group had a pediatric cerebral performance category score ≥4 at discharge (37.9% vs. 16.7%, P = 0.04). In each of the 3 separate multivariable models, COVID-19, the presence of underlying neurologic conditions and shorter time from onset to encephalopathy diagnosis were independently associated with poor prognosis.
CONCLUSIONS: The clinical characteristics of the 2 groups were similar; however, patients with COVID-19-associated encephalopathy showed worse discharge neurologic outcomes, warranting cautious interpretation. Enhancing public awareness of the severe outcomes and conducting further research is essential for better understanding its pathogenesis and treatment.