• Yen-Ju Chu, Lee-Chin Wong, Che-Sheng Ho, Jia-Yun Huang, I-Chun Lee, Hsin-Pei Wang, Cheng-Hsien Huang, Chia-Jui Hsu, Wen-Hsin Hsu, Yu-Chia Kao, Bi-Chun Duan, Inn-Chi Lee, Yung-Ting Kuo, Fu-Man Chang, Su-Ching Hu, Chang-Chun Wu, Lung-Chang Lin, Wan-Ling Hsiao, Chuan-Yu Wang, Kun-Long Hung, Hsiao-Ju Chi, Shi-Bing Wong, and Wang-Tso Lee.
• Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: yenjuchu@ntu.edu.tw.
• J Formos Med Assoc. 2024 Jul 1; 123 (7): 811817811-817.

BackgroundThe SARS-CoV-2 virus has been a global public health threat since December 2019. This study aims to investigate the neurological characteristics and risk factors of coronavirus disease 2019 (COVID-19) in Taiwanese children, using data from a collaborative registry.MethodsA retrospective, cross-sectional, multi-center study was done using an online network of pediatric neurological COVID-19 cohort collaborative registry.ResultsA total of 11160 COVID-19-associated emergency department (ED) visits and 1079 hospitalizations were analyzed. Seizures were the most common specific neurological symptom, while encephalitis and acute disseminated encephalomyelitis (ADEM) was the most prevalent severe involvement. In ED patients with neurological manifestations, severe neurological diagnosis was associated with visual hallucination, seizure with/without fever, behavior change, decreased GCS, myoclonic jerk, decreased activity/fatigue, and lethargy. In hospitalized patients with neurological manifestations, severe neurological diagnosis was associated with behavior change, visual hallucination, decreased GCS, seizure with/without fever, myoclonic jerk, fatigue, and hypoglycemia at admission. Encephalitis/ADEM was the only risk factor for poor neurological outcomes at discharge in hospitalized patients.ConclusionNeurological complications are common in pediatric COVID-19. Visual hallucination, seizure, behavior change, myoclonic jerk, decreased GCS, and hypoglycemia at admission are the most important warning signs of severe neurological involvement such as encephalitis/ADEM.Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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