Analysis of clinical characteristics of febrile seizures in children with COVID-19: a retrospective study

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COVID-19 can invade the central nervous system, cause abnormalities in the nervous system, and is associated with an increased incidence of febrile seizures in children. This study is to compare the differences in clinical features, hematological features, and cerebrospinal fluid characteristics between COVID-19 and non-COVID-19 children with febrile seizures and to explore the clinical characteristics of febrile seizures caused by COVID-19. Methods This was a retrospective case-control study. The cases included children with COVID-19 and non-COVID-19 febrile seizures admitted to Xiamen Children's Hospital from December 2022 to December 2023. The age, gender, length of hospital stay, peak body temperature, presence or absence of other viral infections, hematological characteristics, and cerebrospinal fluid characteristics were compared between children with COVID-19 febrile seizures and non-COVID-19 febrile seizures. Results A total of 50 COVID-19 children with febrile seizures and 192 non-COVID-19 children with febrile seizures were enrolled in this study. Multivariate analysis showed that age (OR=0.715, P =0.031), blood urea nitrogen (OR=0.454, P =0.029), platelet count (OR=0.987, P =0.009), and magnesium ion concentration (OR=0.109, P <0.001) were independent protective factors for COVID-19 febrile seizures. Albumin (OR=1.840, P <0.001) was an independent risk factor. The concentration of potassium ions in cerebrospinal fluid(OR=4.383, P =0.022)was an independent protective factor, while the concentration of sodium ions (OR=4.383, P =0.022) was an independent risk factor. Conclusion There were differences in age, blood urea nitrogen, platelet count, magnesium ion concentration, albumin, potassium ion concentration in cerebrospinal fluid, and sodium ion concentration in the cerebrospinal fluid between children with COVID-19 febrile seizures and non-COVID-19 febrile seizures. This study may provide valuable insights into the potential mechanisms of COVID-19 damage to the nervous system in children, and the long-term neurological prognosis of these children requires long-term follow-up. COVID-19 febrile seizures children nervous system Introduction COVID-19 was first reported in China in December 2019 and has since spread globally. China opened the COVID-19 on December 7, 2022, which led to the widespread spread of COVID-19 in China, and children were not spared(1, 2). COVID-19 can directly invade the central nervous system or cause abnormalities in the nervous system through an inflammatory response mediated by a cytokine storm(3). Studies have shown that the incidence of abnormal electroencephalograms increases significantly in children infected with COVID-19, and pediatric patients infected with COVID-19 and with neurological symptoms may have encephalopathy(4). Recent studies from the United States(5), South Korea(6), and Japan(7) have shown an association between COVID-19 and an increased incidence of Febrile seizures (FS) in children. To date, data on FS in children affected by COVID-19 remain scarce. There are few studies on the true prevalence, frequency, and characteristics of COVID-19-related FS(5, 7–9). FS is the most common seizure disorder in children, defined as seizures accompanied by fever (body temperature ≥ 38°C) without central nervous system infection(10). In the United States and Western Europe, the prevalence of FS ranges from 2–5%, while in Japan, it ranges from 6–9%(11–13). There are differences between the Asian countries that report the incidence of FS and higher, ranging from 1–14%(13). Considering the association between COVID-19 and increased incidence of FS, COVID-19 has significant effects on the nervous system; patients with COVID-19 complicated with FS may have unique clinical features, and there is a lack of research on risk factors associated with FS in children with COVID-19 infection. Therefore, we tried to compare the differences in clinical features, hematological characteristics, and cerebrospinal fluid characteristics between COVID-19 and non-COVID-19 children with FS in order to explore the clinical characteristics of seizures caused by COVID-19 and improve the understanding of clinical medical staff on the characteristics of FS in children with COVID-19. Methods Study design and participants This was a retrospective case-control study. We collected medical records of COVID-19 FS and non-COVID-19 FS in children under 14 years old in Xiamen Children's Hospital from December 2022 to December 2023. The case group was children with COVID-19 FS, and the control group was children with non-COVID-19 FS. The International League against Epilepsy defines FS as seizures caused by high fever (over 38℃) but without previous neonatal seizures, central nervous system infection, inflammation, or acute systemic metabolic abnormalities that can induce seizures(10). Children with central nervous system infections, chronic neurodevelopmental problems, underlying epilepsy, or epilepsy due to other cerebral disorders were excluded. Data collection The demographic and clinical data of the case group and the control group were collected by consulting the hospital's electronic medical record system, including age, gender, length of hospital stay, peak body temperature, presence or absence of other viral infections, relevant laboratory hematological data and cerebrospinal fluid data after admission. Data analysis SPSS 21.0 was used to analyze the data. The measurement data in accordance with normal distribution were represented by the mean ± standard deviation (𝑥 ±𝑠). The skewed distribution was represented by the median and interquartile range ( P 50 ( P 25, P 75)). Count data were expressed as frequency (n) and percentage (%). In univariate analysis, the measurement data between the groups was typically distributed using the t-test, and the non-parametric rank sum test was used for skewed distribution. Count data were expressed as the number of cases or constituent ratio (%), and the chi-square test or Fisher exact probability method was used. Variables with statistically significant differences ( P < 0.05) were entered into multivariate analysis. In multivariate analysis, binary logistic regression was used, with the presence or absence of FS of COVID-19 as the dependent variable and each indicator as the independent variable. Results General information 50 COVID-19 children with FS and 192 non-COVID-19 children with FS were enrolled in this study. The median age of the COVID-19 group was 3.72 years, including 37 males (74.00%) and 13 females (26.00%), the median length of hospital stay was 4.5 days and the mean peak temperature was 38.62℃. The median age of the non-COVID-19 group was 2.16 years, including 108 males (56.25%) and 84 females (43.75%), the median length of hospital stay was four days and the median peak temperature was 38.10℃. Univariate analysis showed that age, gender and peak temperature were statistically different between the two groups ( P < 0.05). Table 1 summarizes the demographic characteristics of the study population. Table 1 The demographic characteristics of the patients. Categories COVID-19 FS group (N = 50) Non-COVID-19 FS group (N = 192) P value Age (years) 3.72 (2.75, 4.73) 2.16 (0.38, 5.99) 0.007 Gender Female 13 (26.00%) 84 (43.75%) 0.024 Male 37 (74.00%) 108 (56.25%) Length of stay 4.5 (3, 6) 4 (3, 7) 0.757 Peak temperature (℃) 38.62 ± 0.82 38.10 (37.03, 38.88) <0.001 Co-infection with other viruses The results of this study showed that metapneumovirus infection was statistically different between the COVID-19 group and the non-COVID-19 group of FS. The results as shown in Table 2 . Table 2 Co-infection with other viruses of the patients. Categories COVID-19 FS group (N = 50) Non-COVID-19 FS group (N = 192) P value Influenza A virus negative 50 185 0.350 positive 0 7 Seasonal H3N2 virus negative 50 192 0.210 positive 0 0 Influenza B virus negative 50 183 0.793 positive 0 9 Parainfluenza virus negative 49 191 0.502 positive 1 1 Coronavirus negative 50 190 0.793 positive 0 2 Respiratory syncytial virus negative 49 191 0.481 positive 1 1 Rhinovirus negative 49 185 0.892 positive 1 7 Bocavirus negative 49 190 0.502 positive 1 2 Human metapneumovirus negative 47 191 0.029 positive 3 1 Adenovirus negative 49 189 0.606 positive 1 3 Mycoplasma pneumoniae negative 49 188 0.724 positive 1 4 Laboratory tests The relevant laboratory test values for the COVID-19 FS group and the non-COVID-19 FS group were shown in Table 3 . Univariate analysis showed that there were statistically significant differences in white blood cell count, red blood cell count, neutrophil count, platelet count, CRP, phosphorus, chloride, calcium, potassium, magnesium, lactate dehydrogenase, glutamyl transpeptidase, aspartate aminotransferase, alanine aminotransferase, phosphocreatine kinase, albumin, urea nitrogen and creatinine between the two groups. Table 3 The laboratory tests of the patients. Categories COVID-19 FS group (N = 50) Non-COVID-19 FS group (N = 192) P value WBC 8.96 ± 2.42 8.06 ± 2.68 0.033 RBC 4.58 (4.30, 4.77) 4.37 (4.11, 4.68) 0.012 Eosinophils 0.12 (0.09, 0.17) 0.13 (0.06, 0.20) 0.752 Basophilic granulocyte 0.02 (0.02, 0.03) 0.03 (0.02, 0.04) 0.106 Monocyte 0.94 ± 0.29 0.93 ± 0.41 0.936 Neutrophile granulocyte 4.78 (3.14, 5.80) 3.62 ± 2.10 <0.001 Lymphocyte 2.93 ± 1.08 3.28 (1.96, 4.22) 0.311 PLT 260.80 ± 56.86 286.00 (233.25, 359.50) 0.019 HGB 121.78 ± 8.05 118.69 (112.05, 127.88) 0.169 CRP 4.26 (1.78, 6.98) 2.27 (0.71, 6.42) 0.016 Phosphorus 1.56 (1.44, 1.58) 1.59 (1.47, 1.59) 0.014 Chlorine 102.59 ± 1.73 103.12 (102.94, 103.79) <0.001 Calcium 9.48 (9.27, 9.73) 9.36 (9.17, 9.40) 0.001 Sodium 136.63 (136.26, 137.73) 136.84 (136.66, 137.44) 0.320 Potassium 4.09 ± 0.26 4.19 (3.95, 4.19) 0.044 Magnesium 0.85 (0.78, 0.86) 0.89 (0.86, 0.91) <0.001 Lactic dehydrogenase 305.82 ± 43.35 324.43 (279.48, 368.70) 0.035 Glutamyl transpeptidase 11.14 (9.83, 14.03) 15.20 (11.00, 31.00) <0.001 Glutamic oxalacetic transaminase 39.50 (35.36, 44.25) 44.00 (34.40, 59.48) 0.011 Glutamic-pyruvic transaminase 18.25 (14.00, 23.00) 24.00 (16.53, 40.23) <0.001 Creatine kinase isoenzyme 30.38 (25.94, 36.66) 33.69 ± 15.34 0.696 Creatine phosphate kinase 180.30 (138.83, 268.00) 152.25 (107.75, 199.75) 0.001 Alkaline phosphatase 209.22 ± 42.88 214.42 (165.25, 269.75) 0.365 Glucose 5.84 (5.58, 6.21) 5.86 (5.71, 5.91) 0.294 Albumin 43.17 ± 2.16 39.75 (37.80, 41.99) <0.001 Globulin 23.97 (21.60, 26.50) 25.32 ± 5.35 0.245 Blood urea nitrogen 3.96 ± 0.86 4.03 (4.03, 4.03) 0.027 Creatinine 32.05 (26.65, 39.43) 28.15 (23.90, 35.43) 0.011 Predictors of FS in children infected with COVID-19 The variables with statistically significant differences ( P <0.05) after univariate analysis were included in multivariate analysis. The results showed that age, magnesium, albumin, urea nitrogen, and platelet count were independent influencing factors for FS in children with COVID-19. Among them, age (OR = 0.715, P = 0.031), urea nitrogen (OR = 0.454, P = 0.029), platelet count (OR = 0.987, P = 0.009), magnesium ion (OR = 0.109, P < 0.001) were independent protective factors, and albumin (OR = 1.840, P < 0.001) was an independent risk factor. The results are shown in Table 4 . Table 4 Multivariate analysis of influencing factors for FS in children with COVID-19 Categories B Wald chi-square P value Exp ( B ) EXP( B ) 95% C.I. lower limit upper limit Age -0.336 4.650 0.031 0.715 0.527 0.970 Gender -1.100 3.086 0.079 0.333 0.098 1.136 Peak temperature -0.011 0.066 0.797 0.989 0.911 1.074 Human metapneumovirus 2.623 1.792 0.181 13.782 0.296 641.696 Phosphorus -1.115 0.374 0.541 0.328 0.009 11.716 Chlorine 0.011 0.053 0.819 1.011 0.920 1.112 Calcium 1.598 2.232 0.135 4.944 0.608 40.238 Potassium 0.790 0.401 0.526 2.204 0.191 25.400 Magnesium -20.104 18.132 <0.001 0.109 0.126 20.231 Lactic dehydrogenase 0.001 0.027 0.869 1.001 0.990 1.012 Glutamyl transpeptidase 0.005 0.052 0.819 1.005 0.966 1.044 Glutamic oxalacetic transaminase -0.051 1.048 0.306 0.950 0.862 1.048 Glutamic-pyruvic transaminase -0.062 1.833 0.176 0.940 0.860 1.028 Creatine phosphate kinase 0.002 1.132 0.287 1.002 0.998 1.005 Albumin 0.610 16.662 <0.001 1.840 1.373 2.465 Blood urea nitrogen -0.790 4.768 0.029 0.454 0.223 0.922 Creatinine 0.002 0.001 0.972 1.002 0.916 1.095 WBC 0.100 0.140 0.708 1.105 0.655 1.865 RBC 0.691 1.503 0.220 1.996 0.661 6.029 Neutrophile 0.465 2.280 0.131 1.592 0.871 2.909 PLT -0.013 6.859 0.009 0.987 0.978 0.997 CRP 0.009 0.052 0.820 1.009 0.936 1.088 Comparison of cerebrospinal fluid parameters As shown in Table 5 , the medians of cerebrospinal fluid protein, chloride, potassium, sodium, lactate dehydrogenase, and MTP of children with FS without COVID-19 were 0.15g/L, 122.00mmol/L, 2.70mmol/L, 142.45mmol/L, 15.00U/L, and 0.21g/L. COVID-19 children with FS were 0.18g/L, 123.05mmol/L, 2.65mmol/L, 143.40mmol/L, 19.00U/L and 0.44g/L. The results showed statistical differences between the two groups in the four indexes of CSF protein, potassium, sodium, and MTP. Table 5 Cerebrospinal fluid parameters of the patients Categories Non-COVID-19 FS group (N = 45) COVID-19 FS group (N = 27) P value Cerebrospinal fluid protein 0.15 (0.12, 0.20) 0.18 (0.15, 0.50) 0.002 Chlorine 122.00 (120.80, 125.05) 123.05 (120.90, 124.80) 0.573 Potassium 2.70 (2.70, 2.70) 2.65 (2.65, 2.65) <0.001 Sodium 142.45 (142.45, 142.45) 143.40 (143.40, 143.40) <0.001 Lactic dehydrogenase 15.00 (12.00, 20.00) 19.00 (13.00, 25.00) 0.078 MTP 0.21 (0.15, 0.21) 0.44 (0.17, 0.44) 0.001 The variables with statistically significant differences ( P < 0.05) after univariate analysis were included in the multivariate analysis. As shown in Table 6 , potassium (OR = 0.334, P = 0.012) was an independent protective factor, and sodium (OR = 4.383, P = 0.022) was an independent risk factor. Table 6 Multivariate analysis of cerebrospinal fluid data of FS in children with COVID-19 Categories B Wald chi-square P value Exp ( B ) EXP( B ) 95% C.I. lower limit upper limit Cerebrospinal fluid protein 0.033 0.002 0.964 1.033 0.251 4.250 Potassium -38.531 16.557 0.012 0.334 0.124 13.223 Sodium 1.478 5.209 0.022 4.383 1.232 15.590 MTP 6.351 3.381 0.066 572.969 0.658 498931.971 Discussion This study showed that although the number of children with FS in the COVID-19 group was lower than that in the non-COVID-19 group, all conditions were equal, this does not mean that COVID-19 infection reduces the risk of FS. Rather, it may reflect a significant increase in the overall incidence of FS caused by COVID-19 infection. This was consistent with the results of multiple studies(14, 15). A South African study found that 20% of 139 children under the age of 13 admitted to hospital with COVID-19 had seizures(16). A study in Sweden also found that four children with COVID-19 experienced seizures in just one week(17). The main mechanism by which COVID-19 causes a series of nervous system symptoms is that it invades host cells by binding to angiotensin-converting enzyme 2 and is expressed on the surface of various nerve cells(18), leading to seizures, headache, paralysis, and other symptoms(19). However, the severity of neurological sequelae of COVID-19 may need to be studied long enough to be explored in depth. By identifying differences in the clinical features of seizures in children caused by COVID-19, it may be crucial to elucidate the pathophysiology and potential possibilities of COVID-19 damage to the CNS in the future. Consistent with the Swedish study, boys were more likely to have seizures regardless of COVID-19 infection(17). However, the sample size was too small to assert a gender preference in the occurrence of COVID-19 seizures, and the results of this study may help to test this idea. This study found that age was an independent protective factor for FS in COVID-19, consistent with previous studies(20, 21). Younger children have immature brain development, higher neuronal excitability, lower blood-brain barrier integrity, and lower tolerance to external stimulation. They are more susceptible to nervous system damage caused by viral infection and increase the risk of seizures. This study found that blood urea nitrogen level was an independent protective factor for COVID-19 FS. Urea nitrogen is the end product of protein metabolism in the body, and its level reflects the state of protein metabolism in the body(22). Urea nitrogen can inhibit glutamate receptor activity, reduce neuronal excitability, and may affect the permeability of the blood-brain barrier, limiting the entry of neurotoxic substances into the central nervous system, thereby helping to maintain the homeostasis of the central nervous system and reducing the risk of convulsion(22). This is in order to investigate the pathophysiology of FS and further provide a new perspective. The results of this study indicated that albumin was an independent risk factor for FS in COVID-19. As a harmful acute-phase protein, the increase of albumin usually reflects some degree of inflammation. Inflammatory mediators may act directly on the central nervous system, increasing seizure susceptibility (23). This study showed that platelets were an independent protective factor for COVID-19 FS. Platelets are essential in neurotransmitter release and vasoconstriction processes, and their abnormalities may affect neuronal excitability(24). Platelets are also involved in regulating the inflammatory response, and their reduction may aggravate the central nervous system damage caused by COVID-19(25). Electrolyte imbalances that may affect the neurotransmitter release and conduction cause neuronal excitability change, thus inducing seizure(26, 27). This study showed that decreased potassium and increased sodium ions in cerebrospinal fluid were independent risk factors for FS in COVID-19. Potassium imbalance can cause changes in neuronal membrane potential, enhance excitability, and induce seizures(28). Sodium imbalance can lead to cellular edema, cause neuronal dysfunction, and increase susceptibility to seizures(29, 30). Studies have shown that CSF electrolyte levels can more directly reflect the pathological changes of the central nervous system and are critical biological markers of FS(31). Therefore, cerebrospinal fluid electrolyte indicators may be superior to hematological indicators in predicting and explaining the occurrence of FS, which also provides an essential basis for the study of the pathogenesis of COVID-19 FS and formulation of prevention and treatment strategies. Our study also has some limitations. First, we had limited data on the cerebrospinal fluid, which was obtained only when there was clinical suspicion of intracranial infection. Second, since this study was conducted after the COVID-19 prevention and control policy was opened in China during the Omicron period, the results may be inconsistent for other variants. Third, as it is a retrospective study, the data collected are limited and lack more specific descriptions, such as the duration of seizures. More detailed FS data reports can be added to explore the pathogenesis further, and perhaps more surprising findings can be obtained. Conclusion In conclusion, this study provides valuable insights into the underlying mechanisms of neurological damage caused by COVID-19 in children. The results showed that age, blood urea nitrogen, platelet count, and magnesium ion were independent protective factors, and albumin was an independent risk factor. In the cerebrospinal fluid, potassium was an independent protection factor, and sodium ions were an independent risk factor. In the future, further studies are needed to elucidate the underlying mechanisms associated with FS in COVID-19 patients, and continuous follow-up of such patients is needed to verify their neurological effects. Abbreviations FS Febrile seizures Declarations Ethics approval and consent to participate The study was approved by the Ethics Committee of Xiamen Children's Hospital. This study was a retrospective study, and the Ethics Committee of Xiamen Children's Hospital waived the requirement of informed consent and removed all identifying information to protect patient confidentiality. This study was conducted in accordance with the Declaration of Helsinki and local institutional standards. Consent for publication Not applicable. Availability of data and materials Might be provided upon request to the corresponding author. The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding Fujian Provincial Health Commission science and technology plan project (No. 2022TG027), Xiamen Natural Science Foundation Project (No. 3502Z202373137), Key Program of the Xiamen Medical and Health (No. 3502Z20234013), The Innovation and Entrepreneurship Project for High-level Talents in Medical and Health Fields of Quanzhou Science and Technology Bureau (No. 2023C014YR), Construction of Clinical Key Discipline in Xiamen Children’s Hospital (No. XE2022-YNPY-A03). Authors' contributions NXZ and RMY conceived and designed the article. Administrative support was provided by XHH and DYZ. NXZ, RMY, XHH, and DYZ provided study materials or patients. NXZ, RMY, FYL, DL, and YL collected and assembled the data. WTL and GHW analyzed and interpreted the data. All authors contributed to writing and final approval of the manuscript. Acknowledgements Not applicable. References Zheng L, Liu S, Lu F. 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Cite Share Download PDF Status: Published Journal Publication published 05 Dec, 2024 Read the published version in BMC Infectious Diseases → Version 1 posted Editorial decision: Revision requested 12 Sep, 2024 Reviews received at journal 11 Sep, 2024 Reviews received at journal 04 Sep, 2024 Reviews received at journal 02 Sep, 2024 Reviewers agreed at journal 28 Aug, 2024 Reviewers agreed at journal 26 Aug, 2024 Reviewers agreed at journal 26 Aug, 2024 Reviewers agreed at journal 21 Aug, 2024 Reviews received at journal 14 Aug, 2024 Reviewers agreed at journal 14 Aug, 2024 Reviewers invited by journal 14 Aug, 2024 Editor invited by journal 02 Jul, 2024 Editor assigned by journal 29 Jun, 2024 Submission checks completed at journal 29 Jun, 2024 First submitted to journal 28 Jun, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4652760","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":322889369,"identity":"a59d6bab-4645-4957-9fd1-c2597cf8ef60","order_by":0,"name":"Nanxi Zhu","email":"","orcid":"","institution":"Children's Hospital of Fudan University (Xiamen Branch), Xiamen Children's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Nanxi","middleName":"","lastName":"Zhu","suffix":""},{"id":322889370,"identity":"fd32a4a5-00b4-425b-9e83-76d6dc00b877","order_by":1,"name":"Ruming Ye","email":"","orcid":"","institution":"Children's Hospital of Fudan University (Xiamen Branch), Xiamen Children's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ruming","middleName":"","lastName":"Ye","suffix":""},{"id":322889371,"identity":"398de4f2-c7e3-480a-a5cd-0f27b4fb09ef","order_by":2,"name":"Fangyi Liu","email":"","orcid":"","institution":"Jinjiang Municipal Hospital","correspondingAuthor":false,"prefix":"","firstName":"Fangyi","middleName":"","lastName":"Liu","suffix":""},{"id":322889372,"identity":"36a69d27-147a-439e-830b-2556ca15b41c","order_by":3,"name":"Dan Li","email":"","orcid":"","institution":"Children's Hospital of Fudan University (Xiamen Branch), Xiamen Children's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Dan","middleName":"","lastName":"Li","suffix":""},{"id":322889373,"identity":"7656dbb5-0e47-43dc-b7bd-1b7f5a20b607","order_by":4,"name":"Ying Lin","email":"","orcid":"","institution":"Children's Hospital of Fudan University (Xiamen Branch), Xiamen Children's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ying","middleName":"","lastName":"Lin","suffix":""},{"id":322889374,"identity":"510730cd-79ce-431f-b21e-cc3af2dd4146","order_by":5,"name":"Wanting Li","email":"","orcid":"","institution":"Children's Hospital of Fudan University (Xiamen Branch), Xiamen Children's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Wanting","middleName":"","lastName":"Li","suffix":""},{"id":322889375,"identity":"60f622d6-0602-4a7c-9227-76b8898ae341","order_by":6,"name":"Guanhong Wu","email":"","orcid":"","institution":"Children's Hospital of Fudan University (Xiamen Branch), Xiamen Children's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Guanhong","middleName":"","lastName":"Wu","suffix":""},{"id":322889376,"identity":"4fab5a93-0df1-42da-a801-5c1f56139640","order_by":7,"name":"Deyi Zhuang","email":"","orcid":"","institution":"Children's Hospital of Fudan University (Xiamen Branch), Xiamen Children's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Deyi","middleName":"","lastName":"Zhuang","suffix":""},{"id":322889377,"identity":"32beadae-2ebd-40ff-8aef-8e158006cab2","order_by":8,"name":"Xianghui Huang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyklEQVRIiWNgGAWjYFACHgZmhgoJHnn2xsaHH4jXcsZGxrDncLOxBNFaGNvSbBhupLcJ8BCjweDa2WPSBWyHeRhnPmxjkGCwk9NtIKBFcnZesvEMnsM87NKJbQ8KGJKNzQ4Q0MIvnWP4mEcCaMvsxHYDCYYDidsIaWGTzjE4zANEDDcPtknwEKMFYktCGg/DDUYitUjOzjE25jlgw2PYkwgMZAMi/GJwO8dMmvefhL08+/GHDz9U2MkR1IJuAmnKR8EoGAWjYBTgAABV4Tx3/fv8pwAAAABJRU5ErkJggg==","orcid":"","institution":"Children's Hospital of Fudan University (Xiamen Branch), Xiamen Children's Hospital","correspondingAuthor":true,"prefix":"","firstName":"Xianghui","middleName":"","lastName":"Huang","suffix":""}],"badges":[],"createdAt":"2024-06-28 07:14:20","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4652760/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4652760/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12879-024-10287-2","type":"published","date":"2024-12-05T15:57:44+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":70965267,"identity":"09d4c79a-20a9-4b1d-a541-4c52eae3ff13","added_by":"auto","created_at":"2024-12-09 16:18:27","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":826684,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4652760/v1/9366e1f1-fb7a-4863-ad18-f8903d245652.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Analysis of clinical characteristics of febrile seizures in children with COVID-19: a retrospective study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eCOVID-19 was first reported in China in December 2019 and has since spread globally. China opened the COVID-19 on December 7, 2022, which led to the widespread spread of COVID-19 in China, and children were not spared(1, 2).\u003c/p\u003e \u003cp\u003eCOVID-19 can directly invade the central nervous system or cause abnormalities in the nervous system through an inflammatory response mediated by a cytokine storm(3). Studies have shown that the incidence of abnormal electroencephalograms increases significantly in children infected with COVID-19, and pediatric patients infected with COVID-19 and with neurological symptoms may have encephalopathy(4).\u003c/p\u003e \u003cp\u003eRecent studies from the United States(5), South Korea(6), and Japan(7) have shown an association between COVID-19 and an increased incidence of Febrile seizures (FS) in children. To date, data on FS in children affected by COVID-19 remain scarce. There are few studies on the true prevalence, frequency, and characteristics of COVID-19-related FS(5, 7\u0026ndash;9).\u003c/p\u003e \u003cp\u003eFS is the most common seizure disorder in children, defined as seizures accompanied by fever (body temperature\u0026thinsp;\u0026ge;\u0026thinsp;38\u0026deg;C) without central nervous system infection(10). In the United States and Western Europe, the prevalence of FS ranges from 2\u0026ndash;5%, while in Japan, it ranges from 6\u0026ndash;9%(11\u0026ndash;13). There are differences between the Asian countries that report the incidence of FS and higher, ranging from 1\u0026ndash;14%(13).\u003c/p\u003e \u003cp\u003eConsidering the association between COVID-19 and increased incidence of FS, COVID-19 has significant effects on the nervous system; patients with COVID-19 complicated with FS may have unique clinical features, and there is a lack of research on risk factors associated with FS in children with COVID-19 infection. Therefore, we tried to compare the differences in clinical features, hematological characteristics, and cerebrospinal fluid characteristics between COVID-19 and non-COVID-19 children with FS in order to explore the clinical characteristics of seizures caused by COVID-19 and improve the understanding of clinical medical staff on the characteristics of FS in children with COVID-19.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and participants\u003c/h2\u003e \u003cp\u003eThis was a retrospective case-control study. We collected medical records of COVID-19 FS and non-COVID-19 FS in children under 14 years old in Xiamen Children's Hospital from December 2022 to December 2023. The case group was children with COVID-19 FS, and the control group was children with non-COVID-19 FS. The International League against Epilepsy defines FS as seizures caused by high fever (over 38℃) but without previous neonatal seizures, central nervous system infection, inflammation, or acute systemic metabolic abnormalities that can induce seizures(10). Children with central nervous system infections, chronic neurodevelopmental problems, underlying epilepsy, or epilepsy due to other cerebral disorders were excluded.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cp\u003eThe demographic and clinical data of the case group and the control group were collected by consulting the hospital's electronic medical record system, including age, gender, length of hospital stay, peak body temperature, presence or absence of other viral infections, relevant laboratory hematological data and cerebrospinal fluid data after admission.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eSPSS 21.0 was used to analyze the data. The measurement data in accordance with normal distribution were represented by the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (\u0026#119909; \u0026plusmn;\u0026#119904;). The skewed distribution was represented by the median and interquartile range (\u003cem\u003eP\u003c/em\u003e 50 (\u003cem\u003eP\u003c/em\u003e 25, \u003cem\u003eP\u003c/em\u003e 75)). Count data were expressed as frequency (n) and percentage (%). In univariate analysis, the measurement data between the groups was typically distributed using the t-test, and the non-parametric rank sum test was used for skewed distribution. Count data were expressed as the number of cases or constituent ratio (%), and the chi-square test or Fisher exact probability method was used. Variables with statistically significant differences (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) were entered into multivariate analysis. In multivariate analysis, binary logistic regression was used, with the presence or absence of FS of COVID-19 as the dependent variable and each indicator as the independent variable.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eGeneral information\u003c/h2\u003e \u003cp\u003e50 COVID-19 children with FS and 192 non-COVID-19 children with FS were enrolled in this study. The median age of the COVID-19 group was 3.72 years, including 37 males (74.00%) and 13 females (26.00%), the median length of hospital stay was 4.5 days and the mean peak temperature was 38.62℃. The median age of the non-COVID-19 group was 2.16 years, including 108 males (56.25%) and 84 females (43.75%), the median length of hospital stay was four days and the median peak temperature was 38.10℃. Univariate analysis showed that age, gender and peak temperature were statistically different between the two groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e summarizes the demographic characteristics of the study population.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe demographic characteristics of the patients.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCOVID-19 FS group\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNon-COVID-19 FS group\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;192)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.72 (2.75, 4.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.16 (0.38, 5.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.007\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13 (26.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e84 (43.75%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e0.024\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37 (74.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e108 (56.25%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLength of stay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.5 (3, 6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (3, 7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.757\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePeak temperature (℃)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38.62\u0026thinsp;\u0026plusmn;\u0026thinsp;0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38.10 (37.03, 38.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eCo-infection with other viruses\u003c/h2\u003e \u003cp\u003eThe results of this study showed that metapneumovirus infection was statistically different between the COVID-19 group and the non-COVID-19 group of FS. The results as shown in Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCo-infection with other viruses of the patients.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCOVID-19 FS group\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNon-COVID-19 FS group\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;192)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eInfluenza A virus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e185\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.350\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSeasonal H3N2 virus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e192\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.210\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eInfluenza B virus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.793\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eParainfluenza virus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.502\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCoronavirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.793\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRespiratory syncytial virus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.481\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRhinovirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e185\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.892\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBocavirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.502\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHuman metapneumovirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.029\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAdenovirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e189\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.606\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMycoplasma pneumoniae\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e188\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.724\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eLaboratory tests\u003c/h2\u003e \u003cp\u003eThe relevant laboratory test values for the COVID-19 FS group and the non-COVID-19 FS group were shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Univariate analysis showed that there were statistically significant differences in white blood cell count, red blood cell count, neutrophil count, platelet count, CRP, phosphorus, chloride, calcium, potassium, magnesium, lactate dehydrogenase, glutamyl transpeptidase, aspartate aminotransferase, alanine aminotransferase, phosphocreatine kinase, albumin, urea nitrogen and creatinine between the two groups.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe laboratory tests of the patients.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCOVID-19 FS group\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon-COVID-19 FS group\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;192)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWBC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.96\u0026thinsp;\u0026plusmn;\u0026thinsp;2.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.06\u0026thinsp;\u0026plusmn;\u0026thinsp;2.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.033\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRBC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.58 (4.30, 4.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.37 (4.11, 4.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.012\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEosinophils\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.12 (0.09, 0.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.13 (0.06, 0.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.752\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBasophilic granulocyte\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02 (0.02, 0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.03 (0.02, 0.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.106\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonocyte\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.94\u0026thinsp;\u0026plusmn;\u0026thinsp;0.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.93\u0026thinsp;\u0026plusmn;\u0026thinsp;0.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.936\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeutrophile granulocyte\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.78 (3.14, 5.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.62\u0026thinsp;\u0026plusmn;\u0026thinsp;2.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphocyte\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.93\u0026thinsp;\u0026plusmn;\u0026thinsp;1.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.28 (1.96, 4.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.311\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePLT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e260.80\u0026thinsp;\u0026plusmn;\u0026thinsp;56.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e286.00 (233.25, 359.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.019\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHGB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e121.78\u0026thinsp;\u0026plusmn;\u0026thinsp;8.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e118.69 (112.05, 127.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.169\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCRP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.26 (1.78, 6.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.27 (0.71, 6.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.016\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhosphorus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.56 (1.44, 1.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.59 (1.47, 1.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.014\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChlorine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e102.59\u0026thinsp;\u0026plusmn;\u0026thinsp;1.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e103.12 (102.94, 103.79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCalcium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.48 (9.27, 9.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.36 (9.17, 9.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSodium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e136.63 (136.26, 137.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e136.84 (136.66, 137.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.320\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePotassium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.09\u0026thinsp;\u0026plusmn;\u0026thinsp;0.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.19 (3.95, 4.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.044\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMagnesium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.85 (0.78, 0.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.89 (0.86, 0.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLactic dehydrogenase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e305.82\u0026thinsp;\u0026plusmn;\u0026thinsp;43.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e324.43 (279.48, 368.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.035\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlutamyl transpeptidase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.14 (9.83, 14.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.20 (11.00, 31.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlutamic oxalacetic transaminase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39.50 (35.36, 44.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44.00 (34.40, 59.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.011\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlutamic-pyruvic transaminase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18.25 (14.00, 23.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.00 (16.53, 40.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreatine kinase isoenzyme\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30.38 (25.94, 36.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.69\u0026thinsp;\u0026plusmn;\u0026thinsp;15.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.696\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreatine phosphate kinase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e180.30 (138.83, 268.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e152.25 (107.75, 199.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlkaline phosphatase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e209.22\u0026thinsp;\u0026plusmn;\u0026thinsp;42.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e214.42 (165.25, 269.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.365\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlucose\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.84 (5.58, 6.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.86 (5.71, 5.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.294\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43.17\u0026thinsp;\u0026plusmn;\u0026thinsp;2.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.75 (37.80, 41.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlobulin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.97 (21.60, 26.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.32\u0026thinsp;\u0026plusmn;\u0026thinsp;5.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.245\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlood urea nitrogen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.96\u0026thinsp;\u0026plusmn;\u0026thinsp;0.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.03 (4.03, 4.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.027\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreatinine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32.05 (26.65, 39.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.15 (23.90, 35.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.011\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003ePredictors of FS in children infected with COVID-19\u003c/h2\u003e \u003cp\u003eThe variables with statistically significant differences (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05) after univariate analysis were included in multivariate analysis. The results showed that age, magnesium, albumin, urea nitrogen, and platelet count were independent influencing factors for FS in children with COVID-19. Among them, age (OR\u0026thinsp;=\u0026thinsp;0.715, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.031), urea nitrogen (OR\u0026thinsp;=\u0026thinsp;0.454, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.029), platelet count (OR\u0026thinsp;=\u0026thinsp;0.987, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.009), magnesium ion (OR\u0026thinsp;=\u0026thinsp;0.109, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were independent protective factors, and albumin (OR\u0026thinsp;=\u0026thinsp;1.840, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) was an independent risk factor. The results are shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariate analysis of influencing factors for FS in children with COVID-19\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWald chi-square\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eExp (\u003cem\u003eB\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eEXP(\u003cem\u003eB\u003c/em\u003e) 95% C.I.\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003elower limit\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eupper limit\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.336\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.650\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.031\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.715\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.527\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.970\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.086\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.079\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.136\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePeak temperature\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.797\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.989\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.911\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.074\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHuman metapneumovirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.623\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.792\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.181\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13.782\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.296\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e641.696\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhosphorus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.374\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.541\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.328\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e11.716\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChlorine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.819\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.920\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.112\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCalcium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.598\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.232\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.135\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.944\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.608\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e40.238\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePotassium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.790\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.401\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.526\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.204\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e25.400\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMagnesium\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-20.104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e20.231\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLactic dehydrogenase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.869\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.990\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.012\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlutamyl transpeptidase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.819\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.966\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.044\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlutamic oxalacetic transaminase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.048\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.306\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.950\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.862\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.048\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlutamic-pyruvic transaminase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.833\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.176\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.940\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.860\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.028\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreatine phosphate kinase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.287\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.998\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAlbumin\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.610\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.662\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.840\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.373\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.465\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBlood urea nitrogen\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.790\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.768\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.029\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.454\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.223\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.922\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreatinine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.972\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.916\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.095\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWBC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.140\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.708\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.655\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.865\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRBC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.691\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.503\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.220\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.996\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.661\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e6.029\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeutrophile\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.465\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.280\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.592\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.871\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.909\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePLT\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.859\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.009\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.987\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.978\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.997\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCRP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.820\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.936\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.088\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eComparison of cerebrospinal fluid parameters\u003c/h2\u003e \u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e, the medians of cerebrospinal fluid protein, chloride, potassium, sodium, lactate dehydrogenase, and MTP of children with FS without COVID-19 were 0.15g/L, 122.00mmol/L, 2.70mmol/L, 142.45mmol/L, 15.00U/L, and 0.21g/L. COVID-19 children with FS were 0.18g/L, 123.05mmol/L, 2.65mmol/L, 143.40mmol/L, 19.00U/L and 0.44g/L. The results showed statistical differences between the two groups in the four indexes of CSF protein, potassium, sodium, and MTP.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eCerebrospinal fluid parameters of the patients\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNon-COVID-19 FS group\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;45)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCOVID-19 FS group\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;27)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCerebrospinal fluid protein\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.15 (0.12, 0.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.18 (0.15, 0.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChlorine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e122.00 (120.80, 125.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e123.05 (120.90, 124.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.573\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePotassium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.70 (2.70, 2.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.65 (2.65, 2.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSodium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e142.45 (142.45, 142.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e143.40 (143.40, 143.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLactic dehydrogenase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15.00 (12.00, 20.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19.00 (13.00, 25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.078\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMTP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.21 (0.15, 0.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.44 (0.17, 0.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe variables with statistically significant differences (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) after univariate analysis were included in the multivariate analysis. As shown in Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e, potassium (OR\u0026thinsp;=\u0026thinsp;0.334, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.012) was an independent protective factor, and sodium (OR\u0026thinsp;=\u0026thinsp;4.383, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.022) was an independent risk factor.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariate analysis of cerebrospinal fluid data of FS in children with COVID-19\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWald chi-square\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eExp (\u003cem\u003eB\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eEXP(\u003cem\u003eB\u003c/em\u003e) 95% C.I.\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003elower limit\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eupper limit\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCerebrospinal fluid protein\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.033\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.964\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.033\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4.250\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePotassium\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-38.531\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.557\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.012\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.334\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e13.223\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSodium\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.478\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.022\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.383\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.232\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e15.590\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMTP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.351\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.381\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e572.969\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.658\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e498931.971\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study showed that although the number of children with FS in the COVID-19 group was lower than that in the non-COVID-19 group, all conditions were equal, this does not mean that COVID-19 infection reduces the risk of FS. Rather, it may reflect a significant increase in the overall incidence of FS caused by COVID-19 infection. This was consistent with the results of multiple studies(14, 15). A South African study found that 20% of 139 children under the age of 13 admitted to hospital with COVID-19 had seizures(16). A study in Sweden also found that four children with COVID-19 experienced seizures in just one week(17). The main mechanism by which COVID-19 causes a series of nervous system symptoms is that it invades host cells by binding to angiotensin-converting enzyme 2 and is expressed on the surface of various nerve cells(18), leading to seizures, headache, paralysis, and other symptoms(19). However, the severity of neurological sequelae of COVID-19 may need to be studied long enough to be explored in depth. By identifying differences in the clinical features of seizures in children caused by COVID-19, it may be crucial to elucidate the pathophysiology and potential possibilities of COVID-19 damage to the CNS in the future.\u003c/p\u003e \u003cp\u003eConsistent with the Swedish study, boys were more likely to have seizures regardless of COVID-19 infection(17). However, the sample size was too small to assert a gender preference in the occurrence of COVID-19 seizures, and the results of this study may help to test this idea.\u003c/p\u003e \u003cp\u003eThis study found that age was an independent protective factor for FS in COVID-19, consistent with previous studies(20, 21). Younger children have immature brain development, higher neuronal excitability, lower blood-brain barrier integrity, and lower tolerance to external stimulation. They are more susceptible to nervous system damage caused by viral infection and increase the risk of seizures.\u003c/p\u003e \u003cp\u003eThis study found that blood urea nitrogen level was an independent protective factor for COVID-19 FS. Urea nitrogen is the end product of protein metabolism in the body, and its level reflects the state of protein metabolism in the body(22). Urea nitrogen can inhibit glutamate receptor activity, reduce neuronal excitability, and may affect the permeability of the blood-brain barrier, limiting the entry of neurotoxic substances into the central nervous system, thereby helping to maintain the homeostasis of the central nervous system and reducing the risk of convulsion(22). This is in order to investigate the pathophysiology of FS and further provide a new perspective.\u003c/p\u003e \u003cp\u003eThe results of this study indicated that albumin was an independent risk factor for FS in COVID-19. As a harmful acute-phase protein, the increase of albumin usually reflects some degree of inflammation. Inflammatory mediators may act directly on the central nervous system, increasing seizure susceptibility (23).\u003c/p\u003e \u003cp\u003eThis study showed that platelets were an independent protective factor for COVID-19 FS. Platelets are essential in neurotransmitter release and vasoconstriction processes, and their abnormalities may affect neuronal excitability(24). Platelets are also involved in regulating the inflammatory response, and their reduction may aggravate the central nervous system damage caused by COVID-19(25).\u003c/p\u003e \u003cp\u003eElectrolyte imbalances that may affect the neurotransmitter release and conduction cause neuronal excitability change, thus inducing seizure(26, 27). This study showed that decreased potassium and increased sodium ions in cerebrospinal fluid were independent risk factors for FS in COVID-19. Potassium imbalance can cause changes in neuronal membrane potential, enhance excitability, and induce seizures(28). Sodium imbalance can lead to cellular edema, cause neuronal dysfunction, and increase susceptibility to seizures(29, 30). Studies have shown that CSF electrolyte levels can more directly reflect the pathological changes of the central nervous system and are critical biological markers of FS(31). Therefore, cerebrospinal fluid electrolyte indicators may be superior to hematological indicators in predicting and explaining the occurrence of FS, which also provides an essential basis for the study of the pathogenesis of COVID-19 FS and formulation of prevention and treatment strategies.\u003c/p\u003e \u003cp\u003eOur study also has some limitations. First, we had limited data on the cerebrospinal fluid, which was obtained only when there was clinical suspicion of intracranial infection. Second, since this study was conducted after the COVID-19 prevention and control policy was opened in China during the Omicron period, the results may be inconsistent for other variants. Third, as it is a retrospective study, the data collected are limited and lack more specific descriptions, such as the duration of seizures. More detailed FS data reports can be added to explore the pathogenesis further, and perhaps more surprising findings can be obtained.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, this study provides valuable insights into the underlying mechanisms of neurological damage caused by COVID-19 in children. The results showed that age, blood urea nitrogen, platelet count, and magnesium ion were independent protective factors, and albumin was an independent risk factor. In the cerebrospinal fluid, potassium was an independent protection factor, and sodium ions were an independent risk factor. In the future, further studies are needed to elucidate the underlying mechanisms associated with FS in COVID-19 patients, and continuous follow-up of such patients is needed to verify their neurological effects.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eFS \u0026nbsp; Febrile seizures\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Ethics Committee of Xiamen Children's Hospital. This study was a retrospective study, and the Ethics Committee of Xiamen Children's Hospital waived the requirement of informed consent and removed all identifying information to protect patient confidentiality. This study was conducted in accordance with the Declaration of Helsinki and local institutional standards.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMight be provided upon request to the corresponding author. The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFujian Provincial Health Commission science and technology plan project (No. 2022TG027), Xiamen Natural Science Foundation Project (No. 3502Z202373137), Key Program of the Xiamen Medical and Health (No. 3502Z20234013), The Innovation and Entrepreneurship Project for High-level Talents in Medical and Health Fields of Quanzhou Science and Technology Bureau (No. 2023C014YR), Construction of Clinical Key Discipline in Xiamen Children’s Hospital (No. XE2022-YNPY-A03).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNXZ and RMY conceived and designed the article. Administrative support was provided by XHH and DYZ. NXZ, RMY, XHH, and DYZ provided study materials or patients. NXZ, RMY, FYL, DL, and YL collected and assembled the data.\u0026nbsp;WTL and GHW analyzed and interpreted the data. All authors contributed to writing and final approval of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eZheng L, Liu S, Lu F. Impact of National Omicron Outbreak at the end of 2022 on the future outlook of COVID-19 in China. Emerg Microbes Infect. 2023;12(1):2191738.\u003c/li\u003e\n\u003cli\u003eMohamed ZA, Tang C, Thokerunga E, Deng Y, Fan J. Pediatric infection with the Omicron variant increases the risks of febrile seizures among COVID-19 infected children. Front Pediatr. 2023;11:1226403.\u003c/li\u003e\n\u003cli\u003eMohammadi S, Moosaie F, Aarabi MH. Understanding the Immunologic Characteristics of Neurologic Manifestations of SARS-CoV-2 and Potential Immunological Mechanisms. Mol Neurobiol. 2020;57(12):5263-75.\u003c/li\u003e\n\u003cli\u003eYang Y, Yu T, Yang J, Luo J, Liu X, Mu C, et al. Clinical manifestations and EEG findings in children infected with COVID-19 and exhibiting neurological symptoms. BMC Pediatr. 2024;24(1):49.\u003c/li\u003e\n\u003cli\u003eCadet K, Boegner J, Ceneviva GD, Thomas NJ, Krawiec C. Evaluation of Febrile Seizure Diagnoses Associated With COVID-19. Journal of child neurology. 2022;37(5):410-5.\u003c/li\u003e\n\u003cli\u003eHan MJ, Heo JH, Hwang JS, Jang YT, Lee M, Kim SJ. Incidence of Febrile Seizures in Children with COVID-19. Journal of clinical medicine. 2023;12(3):1076.\u003c/li\u003e\n\u003cli\u003eIijima H, Kubota M, Ogimi C. Change in Seizure Incidence in Febrile Children With COVID-19 in the Era of Omicron Variant of Concern. Journal of the Pediatric Infectious Diseases Society. 2022;11(11):514-7.\u003c/li\u003e\n\u003cli\u003eAntoon JW, Hall M, Howard LM, Herndon A, Freundlich KL, Grijalva CG, et al. COVID-19 and Acute Neurologic Complications in Children. Pediatrics. 2022;150(5):e2022058167.\u003c/li\u003e\n\u003cli\u003eJoung J, Yang H, Choi YJ, Lee J, Ko Y. The Impact of Omicron Wave on Pediatric Febrile Seizure. Journal of Korean medical science. 2023;38(3):e18.\u003c/li\u003e\n\u003cli\u003eProposal for revised clinical and electroencephalographic classification of epileptic seizures. From the Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia. 1981;22(4):489-501.\u003c/li\u003e\n\u003cli\u003eForsgren L, Sidenvall R, Blomquist HK, Heijbel J. A prospective incidence study of febrile convulsions. Acta paediatrica Scandinavica. 1990;79(5):550-7.\u003c/li\u003e\n\u003cli\u003eVestergaard M, Obel C, Henriksen TB, Christensen J, Madsen KM, Ostergaard JR, et al. The Danish National Hospital Register is a valuable study base for epidemiologic research in febrile seizures. Journal of clinical epidemiology. 2006;59(1):61-6.\u003c/li\u003e\n\u003cli\u003eEpilepsy GFESOJE. Commission on Epidemiology and Prognosis, International League Against Epilepsy. 1993:592-6.\u003c/li\u003e\n\u003cli\u003eAhmad S. Neurological Complications of COVID-19 in Children. Pediatric annals. 2021;50(6):e259-e63.\u003c/li\u003e\n\u003cli\u003eGusev EI, Martynov MY, Boyko AN, Voznyuk IA, Latsh NY, Sivertseva SA, et al. The Novel Coronavirus Infection (COVID-19) and Nervous System Involvement: Mechanisms of Neurological Disorders, Clinical Manifestations, and the Organization of Neurological Care. 2021;51(2):147-54.\u003c/li\u003e\n\u003cli\u003eCloete J, Kruger A, Masha M, Du Plessis NM, Mawela D, Tshukudu M, et al. Paediatric hospitalisations due to COVID-19 during the first SARS-CoV-2 omicron (B.1.1.529) variant wave in South Africa: a multicentre observational study. 2022(5):6.\u003c/li\u003e\n\u003cli\u003eLudvigsson JF. Convulsions in children with COVID-19 during the Omicron wave. Acta paediatrica (Oslo, Norway : 1992). 2022;111(5):1023-6.\u003c/li\u003e\n\u003cli\u003eGuo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Military Medical Research. 2020;7(1):11.\u003c/li\u003e\n\u003cli\u003eZubair AS, McAlpine LS, Gardin T, Farhadian S, Kuruvilla DE, Spudich S. Neuropathogenesis and Neurologic Manifestations of the Coronaviruses in the Age of Coronavirus Disease 2019: A Review. JAMA neurology. 2020;77(8):1018-27.\u003c/li\u003e\n\u003cli\u003eNepal G, Shrestha G, Rehrig J, Gajurel B, Ojha R, Agrawal A, et al. Neurological Manifestations of COVID-19 Associated Multi-system Inflammatory Syndrome in Children: A Systematic Review and Meta-analysis. 2021;19(1):10-8.\u003c/li\u003e\n\u003cli\u003eYasuhara J, Watanabe K, Takagi H, Sumitomo N, Kuno T. COVID-19 and multisystem inflammatory syndrome in children: A systematic review and meta-analysis. Pediatric pulmonology. 2021;56(5):837-48.\u003c/li\u003e\n\u003cli\u003eCooper AJLJDDRR. Role of glutamine in cerebral nitrogen metabolism and ammonia neurotoxicity. 2010;7(4):280-6.\u003c/li\u003e\n\u003cli\u003eVezzani A, French J, Bartfai T, Baram TZJNrN. The role of inflammation in epilepsy. 2011(1):7.\u003c/li\u003e\n\u003cli\u003eJunior LSB, Aquino PLDR, Rabelo NN, Aquino MADR, Filho HRCDAJJoNR. SARS-CoV-2 and Nervous System - Neurological Manifestations in Patients With COVID-19: A Systematic Review. 2020;10(4):113-21.\u003c/li\u003e\n\u003cli\u003eRahmati M, Yon DK, Lee SW, Soysal P, Koyanagi A, Jacob L, et al. New‐onset neurodegenerative diseases as long‐term sequelae of SARS‐CoV‐2 infection: A systematic review and meta‐analysis. 2023(7):95.\u003c/li\u003e\n\u003cli\u003ePathan A. Neurological complications and COVID-19: A literature review. 2021:8-12.\u003c/li\u003e\n\u003cli\u003eAlfano G, Fontana F, Mori G, Giaroni F, Guaraldi GJIU, Nephrology. Acid base disorders in patients with COVID-19. 2021:405-10.\u003c/li\u003e\n\u003cli\u003eWhittaker A, Anson M, Harky A. Neurological Manifestations of COVID-19: A systematic review and current update. Acta neurologica Scandinavica. 2020;142(1):14-22.\u003c/li\u003e\n\u003cli\u003eZhai P, Ding Y, Wu X, Long J, Li YJIJoAA. The epidemiology, diagnosis and treatment of COVID-19. 2020;55(5):105955.\u003c/li\u003e\n\u003cli\u003eHui L, Liang L, Dingyu Z, Jiuyang X, Huaping D, Nan T, et al. SARS-CoV-2 and viral sepsis: observations and hypotheses. 2020;395(10235):1517-20.\u003c/li\u003e\n\u003cli\u003eSuryavanshi AR, Bodhgire SB, Anerao RD, Pawar S, Patil AT, Paranjape MJSHR, et al. Clinical profile and cerebrospinal fluid indices in children with complex febrile seizures. 2020(6):634-9.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"COVID-19, febrile seizures, children, nervous system","lastPublishedDoi":"10.21203/rs.3.rs-4652760/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4652760/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTransmission of COVID-19 is now normalized. COVID-19 can invade the central nervous system, cause abnormalities in the nervous system, and is associated with an increased incidence of febrile seizures in children. This study is to compare the differences in clinical features, hematological features, and cerebrospinal fluid characteristics between COVID-19 and non-COVID-19 children with febrile seizures and to explore the clinical characteristics of febrile seizures caused by COVID-19.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis was a retrospective case-control study. The cases included children with COVID-19 and non-COVID-19 febrile seizures admitted to Xiamen Children's Hospital from December 2022 to December 2023. The age, gender, length of hospital stay, peak body temperature, presence or absence of other viral infections, hematological characteristics, and cerebrospinal fluid characteristics were compared between children with COVID-19 febrile seizures and non-COVID-19 febrile seizures.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 50 COVID-19 children with febrile seizures and 192 non-COVID-19 children with febrile seizures were enrolled in this study. Multivariate analysis showed that age (OR=0.715, \u003cem\u003eP\u003c/em\u003e=0.031), blood urea nitrogen (OR=0.454, \u003cem\u003eP\u003c/em\u003e=0.029), platelet count (OR=0.987, \u003cem\u003eP\u003c/em\u003e=0.009), and magnesium ion concentration (OR=0.109, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.001) were independent protective factors for COVID-19 febrile seizures. Albumin (OR=1.840, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.001) was an independent risk factor. The concentration of potassium ions in cerebrospinal fluid(OR=4.383, \u003cem\u003eP\u003c/em\u003e=0.022)was an independent protective factor, while the concentration of sodium ions (OR=4.383, \u003cem\u003eP\u003c/em\u003e=0.022) was an independent risk factor.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere were differences in age, blood urea nitrogen, platelet count, magnesium ion concentration, albumin, potassium ion concentration in cerebrospinal fluid, and sodium ion concentration in the cerebrospinal fluid between children with COVID-19 febrile seizures and non-COVID-19 febrile seizures. This study may provide valuable insights into the potential mechanisms of COVID-19 damage to the nervous system in children, and the long-term neurological prognosis of these children requires long-term follow-up.\u003c/p\u003e","manuscriptTitle":"Analysis of clinical characteristics of febrile seizures in children with COVID-19: a retrospective study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-22 17:20:17","doi":"10.21203/rs.3.rs-4652760/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-09-12T10:02:03+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-09-11T17:31:54+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-09-04T12:11:00+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-09-02T09:59:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"107020336234519544887831790351451559989","date":"2024-08-28T13:30:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"324581515862104381311870855586879304288","date":"2024-08-26T11:34:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"293349349982140227448483730334047807608","date":"2024-08-26T11:27:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"131235064643730780462453382682302308672","date":"2024-08-21T09:35:42+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-08-14T20:07:32+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"177182827566897852141306670117684404710","date":"2024-08-14T19:31:08+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-08-14T06:00:43+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-07-02T08:52:36+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-06-29T16:10:10+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-06-29T16:09:41+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2024-06-28T07:12:30+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"96d490d9-8b21-49ae-a67b-2f26536b32c9","owner":[],"postedDate":"July 22nd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-12-09T16:10:30+00:00","versionOfRecord":{"articleIdentity":"rs-4652760","link":"https://doi.org/10.1186/s12879-024-10287-2","journal":{"identity":"bmc-infectious-diseases","isVorOnly":false,"title":"BMC Infectious Diseases"},"publishedOn":"2024-12-05 15:57:44","publishedOnDateReadable":"December 5th, 2024"},"versionCreatedAt":"2024-07-22 17:20:17","video":"","vorDoi":"10.1186/s12879-024-10287-2","vorDoiUrl":"https://doi.org/10.1186/s12879-024-10287-2","workflowStages":[]},"version":"v1","identity":"rs-4652760","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4652760","identity":"rs-4652760","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}