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FACTORS ASSOCIATED WITH THE SEVERITY OF COVID-19 IN CHILDREN WITH UNDERLYING NEUROLOGICAL CONDITIONS
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Abstract
Objectives: To investigate factors related to the severity of COVID-19 in children with underlying neurological conditions. Methods: A cross-sectional study was carried 97 children with COVID-19 and underlying neurological conditions admitted to the COVID-19 department at Hospital Children 1 from July 1st 2021 to July 1st 2022. Results: There were 76 children (78,4%) with mild to moderate COVID-19, while 21 children (21,6%) experienced severe to critical illness. The mortality rate was 5,2%. Among the severe to critical COVID-19 cases, 71,4% had cerebral palsy, 95,2% presented with fever, 76,2% exhibited cough and 100% experienced respiratory distress. The median ferritin level was 345 (227,7 – 654,7) μg/L, median activated partial thromboplastin time was 34,1 (31,1 – 43,1) s, and median fibrinogen was 3 (2,5 – 3,6) g/L. Additionally, 76,2% showed consolidation on chest X-ray, and 76,2% had interstitial lung pattern. Corticosteroids were used by 95,2% of patients for a median duration of 9 (7 – 10) days, while 95,2% received anticoagulants for a median duration of 10 (8 – 12) days. All patients received antibiotics, and 57,1% were administered remdesivir. The median length of hospital stay for COVID-19 department admission was 12 (8 – 22) days, and for overall hospitalization, it was 15 (11 – 45) days. The mortality rate of the severe to critical COVID-19 group was 23,8%. All these results were significantly higher compared to the mild to moderate COVID-19 group, with statistical significance (p < 0,05). Conclusions: The severity of COVID-19 in children with underlying neurological conditions is associated with several factors: cerebral palsy, fever, cough, respiratory distress, CRP > 20 mg/L, elevated levels of ferritin, aPTT, and fibrinogen, as well as consolidation or interstitial lung pattern on chest X-ray. The utilization rates of corticosteroids, anticoagulants, antibiotics, remdesivir, length of hospital stay, and mortality rates are all higher in the severe-critical group compared to the mild-moderate group.
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Keywords
COVID-19, underlying neurological conditions, severity, children
References
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