Severe central nervous system injury in 9 children with COVID-19

Abstract Purpose To investigate the clinical features and prognosis of severe central nervous system (CNS) injury in children caused by coronavirus disease 2019 (COVID-19). Method We retrospectively studied confirmed pediatric cases of COVID-19 complicated with CNS injury. Results Nine patients diag...

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Main Authors: Peipei Zhang, Meiyun Xin, Yingge Bai, Xueyun Ren, Na Li
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Pediatrics
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Online Access:https://doi.org/10.1186/s12887-025-05436-8
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author Peipei Zhang
Meiyun Xin
Yingge Bai
Xueyun Ren
Na Li
author_facet Peipei Zhang
Meiyun Xin
Yingge Bai
Xueyun Ren
Na Li
author_sort Peipei Zhang
collection DOAJ
description Abstract Purpose To investigate the clinical features and prognosis of severe central nervous system (CNS) injury in children caused by coronavirus disease 2019 (COVID-19). Method We retrospectively studied confirmed pediatric cases of COVID-19 complicated with CNS injury. Results Nine patients diagnosed with COVID-19 complicated with severe CNS injury were admitted to the pediatric intensive care unit of the Affiliated Hospital of Jining University from December 1, 2022 to January 12, 2023. Of the nine patients, seven were male (77.78%). Five children were aged ≥ 10 years, and the others were 1–2 years old. All children had fever, eight had convulsions, seven had progressed to multiple organ failure, and all suffered varying degrees of coma. Most of the children had elevated interleukin-6 (100%), lactic acid (100%), alanine transaminase (87.5%), aspartate transaminase (87.5%), creatine kinase MB (87.5%), and lactate dehydrogenase (85.7%) levels. Four children had cerebrospinal fluid proteinnacell separation. The cranial imaging results of five children were abnormal. One child had lost his vital signs when admitted to hospital, and the remaining eight received hormonal shock, human immunoglobulin transfusion, antinainfection, cranial pressure reduction, and tracheal intubation, among others, during hospitalization. Ultimately, eight children died, and the remaining child has serious neurological sequelae and is undergoing rehabilitation. Conclusions Severe CNS injury caused by COVID-19 has an acute onset, rapid progression, high disability rate, and high fatality rate. A low cerebrospinal fluid protein level may be a protective factor for children with severe nervous system injury caused by COVID-19.
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spelling doaj-art-e77c8148c6a445ffad5719735b0bd3322025-02-02T12:42:44ZengBMCBMC Pediatrics1471-24312025-01-0125111010.1186/s12887-025-05436-8Severe central nervous system injury in 9 children with COVID-19Peipei Zhang0Meiyun Xin1Yingge Bai2Xueyun Ren3Na Li4Department of Pediatrics, Affiliated Hospital of Jining Medical UniversityDepartment of Pediatrics, Affiliated Hospital of Jining Medical UniversitySurrey College, Dongbei University of Finance and EconomicsDepartment of Pediatrics, Affiliated Hospital of Jining Medical UniversityDepartment of Pediatrics, Affiliated Hospital of Jining Medical UniversityAbstract Purpose To investigate the clinical features and prognosis of severe central nervous system (CNS) injury in children caused by coronavirus disease 2019 (COVID-19). Method We retrospectively studied confirmed pediatric cases of COVID-19 complicated with CNS injury. Results Nine patients diagnosed with COVID-19 complicated with severe CNS injury were admitted to the pediatric intensive care unit of the Affiliated Hospital of Jining University from December 1, 2022 to January 12, 2023. Of the nine patients, seven were male (77.78%). Five children were aged ≥ 10 years, and the others were 1–2 years old. All children had fever, eight had convulsions, seven had progressed to multiple organ failure, and all suffered varying degrees of coma. Most of the children had elevated interleukin-6 (100%), lactic acid (100%), alanine transaminase (87.5%), aspartate transaminase (87.5%), creatine kinase MB (87.5%), and lactate dehydrogenase (85.7%) levels. Four children had cerebrospinal fluid proteinnacell separation. The cranial imaging results of five children were abnormal. One child had lost his vital signs when admitted to hospital, and the remaining eight received hormonal shock, human immunoglobulin transfusion, antinainfection, cranial pressure reduction, and tracheal intubation, among others, during hospitalization. Ultimately, eight children died, and the remaining child has serious neurological sequelae and is undergoing rehabilitation. Conclusions Severe CNS injury caused by COVID-19 has an acute onset, rapid progression, high disability rate, and high fatality rate. A low cerebrospinal fluid protein level may be a protective factor for children with severe nervous system injury caused by COVID-19.https://doi.org/10.1186/s12887-025-05436-8COVID-19Severe central nervous system injuryChildren
spellingShingle Peipei Zhang
Meiyun Xin
Yingge Bai
Xueyun Ren
Na Li
Severe central nervous system injury in 9 children with COVID-19
BMC Pediatrics
COVID-19
Severe central nervous system injury
Children
title Severe central nervous system injury in 9 children with COVID-19
title_full Severe central nervous system injury in 9 children with COVID-19
title_fullStr Severe central nervous system injury in 9 children with COVID-19
title_full_unstemmed Severe central nervous system injury in 9 children with COVID-19
title_short Severe central nervous system injury in 9 children with COVID-19
title_sort severe central nervous system injury in 9 children with covid 19
topic COVID-19
Severe central nervous system injury
Children
url https://doi.org/10.1186/s12887-025-05436-8
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AT yinggebai severecentralnervoussysteminjuryin9childrenwithcovid19
AT xueyunren severecentralnervoussysteminjuryin9childrenwithcovid19
AT nali severecentralnervoussysteminjuryin9childrenwithcovid19