Characteristics of febrile seizures with SARS-CoV-2 infection in the Omicron era

Jee Min Kim; Eu Gene Park; Joo Young Lee; Young Hoon Kim; Yeji Kim; Hwan Soo Kim; Yejin Kim; Ji Yoon Han; Seung Beom Han

doi:10.21037/tp-22-579

Characteristics of febrile seizures with SARS-CoV-2 infection in the Omicron era

Transl Pediatr. 2023 May 30;12(5):807-815. doi: 10.21037/tp-22-579. Epub 2023 Apr 27.

Authors

Jee Min Kim¹, Eu Gene Park¹, Joo Young Lee¹, Young Hoon Kim¹, Yeji Kim¹, Hwan Soo Kim¹, Yejin Kim¹, Ji Yoon Han¹, Seung Beom Han²

Affiliations

¹ Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
² Department of Pediatrics, College of Medicine, Hallym University, Chuncheon, Republic of Korea.

Abstract

Background: While the pandemic of coronavirus disease 2019 (COVID-19) is ongoing, the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been dominant recently. The Omicron variant causes more seizures in pediatric patients compared with previously circulated variants. This study aimed to investigate the incidence and clinical features of febrile seizure (FS) in pediatric patients with COVID-19 during the Omicron era.

Methods: The medical records of pediatric patients (≤18 years of age) diagnosed with COVID-19, who presented with FS between February 2020 and June 2022, were reviewed retrospectively to analyze clinical characteristics of FS in seven university-affiliated hospitals of Korea.

Results: Of 664 pediatric patients with COVID-19 during the study period, 46 during the pre-Omicron period and 589 during the Omicron period were included in the study analysis; 29 patients during the transition period were excluded. Among the included patients, 81 (12.8%) had concomitant FS, and most (76.5%) experienced simple FS. All FS episodes occurred during the Omicron period and none of them during pre-Omicron period (P=0.016). Sixty-five (80.2%) and 16 (19.8%) patients were categorized as FS (patient age ≤60 months) and late-onset FS (patient age >60 months), respectively. Underlying neurologic disease (P=0.013) and focal onset seizure (P=0.012) were more common in the late-onset FS group than in the FS group; however, overall clinical manifestations and outcomes including seizures consistent with characteristics of complex FS and subsequent epilepsy were similar between the two groups.

Conclusions: As the COVID-19 pandemic persists, the incidence of FS has increased with the emergence of the Omicron variant. About one-fifth of the patients experiencing FS due to infection by the Omicron variant of SARS-CoV-2 were aged >60 months; however, clinical characteristics and outcomes were favorable. More information and long-term prognoses in patients with FS due to COVID-19 should be acquired.

Keywords: Omicron; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); febrile seizure (FS); late-onset febrile seizure.