Febrile seizure in children with COVID-19 during the Omicron wave

Pu Xu; Xuelian Chen; Jianguo Zhou; Wenhao Zhou; Laishuan Wang

doi:10.3389/fped.2023.1197156

Febrile seizure in children with COVID-19 during the Omicron wave

Front Pediatr. 2023 Oct 20:11:1197156. doi: 10.3389/fped.2023.1197156. eCollection 2023.

Authors

Pu Xu¹, Xuelian Chen², Jianguo Zhou¹, Wenhao Zhou¹, Laishuan Wang¹

Affiliations

¹ National Health Commission Key Laboratory of Neonatal Diseases, Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
² Department of Obstetrics and Gynecology, Renji Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Abstract

Objective: To explore the clinical characteristics and prognosis of febrile seizure in children with COVID-19.

Methods: This study is a single-center retrospective cohort study. The cases included febrile seizures in children with COVID-19 admitted to the Renji Hospital from April 7th, 2022 to June 2nd, 2022. We compared children with and without febrile seizures in their clinical characteristics such as sex, age, symptoms, seizure manifestation, COVID-19 severity, and SARS-CoV-2 nucleic acid test results. The children with febrile seizures were followed up by telephone and outpatient service about one month after the nucleic acid turned negative and discharged from the hospital.

Results: A total of 585 cases of children with COVID-19 were included in the analysis. There were 15 children (1.8%) with febrile seizures, age from six months to three years old, nine boys (60.0%) and six girls (40.0%). The manifestations of febrile seizures were all generalized tonic-clonic seizures. The median nucleic acid negative conversion time was 11 (IQR:10.75,13) days. Our first comparison involved comparing children without underlying diseases; there was no significant difference in sex, COVID-19 severity, and clinical manifestations, but there was an age difference (2 vs. 1.3, P = 0.047). There was no difference in SARS-CoV-2 nucleic acid negative time between the two groups (11d vs. 13d, P = 0.128). One child had new clinical manifestations during the follow-up, but his EEG and MRI were normal.

Conclusion: Febrile seizure may be children's primary neurological manifestation of COVID-19. It may occur in children with no history of epilepsy and is not associated with severe illness. The long-term neurological outcomes of these children should be followed up.

Keywords: COVID-19; Omicron; children; febrile convulsions; febrile seizures.

Grants and funding

Supported in part by a grant from the National Key Research and Development Program of China (2021YFC2701800, 2021YFC2701801) and the Shanghai Municipal Science and Technology Major Project (ZD2021CY001).