Neurological Complications, Mortality Risk Factors, and Prognosis in Pediatric COVID-19 Patients: Insights from a Three-Year Prospective Study at the University Children’s Hospital in Damascus.

Neurological Complications, Mortality Risk Factors, and Prognosis in Pediatric COVID-19 Patients: Insights from a Three-Year Prospective Study at the University Children’s Hospital in Damascus. | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Neurological Complications, Mortality Risk Factors, and Prognosis in Pediatric COVID-19 Patients: Insights from a Three-Year Prospective Study at the University Children’s Hospital in Damascus. Maysaa Badour, Nafiza Martini, Majd Hanna, Karam Kababeh, Imad-Addin Almasri, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4557613/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background and Aim: The COVID-19 pandemic caused by the SARS-CoV-2 virus has had a significant global impact, but its neurological manifestations in children have received limited attention. The aim of this study was to prospectively examine the neurological complications, identify mortality risk factors, and assess the predictive value of biomarkers in pediatric COVID-19 patients. Methods A prospective cohort study was conducted from 2020 to 2023. Children aged from the neonatal period to 13 years, hospitalized with confirmed COVID-19, were included. Data on demographics, neurological comorbidities, symptoms, neurological examination findings, radiological and electrophysiological results, laboratory findings, treatments, and outcomes were collected. Chi-square tests and ROC curves were performed. Results Among the 66 hospitalized children, seizures (59.1%) and altered consciousness (30.3%) were common neurological manifestations. The occurrence of seizures correlated significantly with gender, with males having a higher likelihood of developing epilepsy (P = 0.0044). Seizures were also found to be a risk factor for death, as the majority of children who died had experienced seizures (P = 0.046). Encephalopathy and encephalopathy in MIS-C were also associated with increased mortality (P = 0.013, < 0.001, respectively). Treatment with Dixon negatively impacted outcomes (P = 0.006), while Immunoglobulins had a positive effect (0.019). Biomarkers including CRP, GPT, BUN, and creatinine were all found to be correlated with death, with elevated values indicating higher mortality risk (P < 0.001). Finally, Mechanical ventilation was associated with higher mortality rates (P = 0.008). Conclusion This study provides significant contributions to our understanding of COVID-19 in children, particularly in terms of clinical and neurological aspects, risk factors, and prognosis. The findings emphasize the importance of early detection, monitoring of biomarkers, and the incorporation of these insights into healthcare policies. By recognizing the unique challenges and implications of COVID-19 in pediatric patients, healthcare providers can enhance patient care and optimize outcomes in the midst of the ongoing pandemic. COVID-19 Neurological complications Pediatric Risk factors Prognosis Prospective Study Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted 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. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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-4557613","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":319470660,"identity":"c5cec90b-0ef1-4f65-b641-9066554280cf","order_by":0,"name":"Maysaa Badour","email":"","orcid":"","institution":"Pediatric Department, Faculty of Medicine, Damascus University","correspondingAuthor":false,"prefix":"","firstName":"Maysaa","middleName":"","lastName":"Badour","suffix":""},{"id":319470661,"identity":"b8c5bff4-25e5-46b7-a440-c0459d88e3c3","order_by":1,"name":"Nafiza Martini","email":"","orcid":"","institution":"Faculty of Medicine, 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Neurological complications, Pediatric, Risk factors, Prognosis, Prospective Study","lastPublishedDoi":"10.21203/rs.3.rs-4557613/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4557613/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground and Aim:\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe COVID-19 pandemic caused by the SARS-CoV-2 virus has had a significant global impact, but its neurological manifestations in children have received limited attention. The aim of this study was to prospectively examine the neurological complications, identify mortality risk factors, and assess the predictive value of biomarkers in pediatric COVID-19 patients.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003eA prospective cohort study was conducted from 2020 to 2023. Children aged from the neonatal period to 13 years, hospitalized with confirmed COVID-19, were included. Data on demographics, neurological comorbidities, symptoms, neurological examination findings, radiological and electrophysiological results, laboratory findings, treatments, and outcomes were collected. Chi-square tests and ROC curves were performed.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eAmong the 66 hospitalized children, seizures (59.1%) and altered consciousness (30.3%) were common neurological manifestations. The occurrence of seizures correlated significantly with gender, with males having a higher likelihood of developing epilepsy (P\u0026thinsp;=\u0026thinsp;0.0044). Seizures were also found to be a risk factor for death, as the majority of children who died had experienced seizures (P\u0026thinsp;=\u0026thinsp;0.046). Encephalopathy and encephalopathy in MIS-C were also associated with increased mortality (P\u0026thinsp;=\u0026thinsp;0.013, \u0026lt;\u0026thinsp;0.001, respectively). Treatment with Dixon negatively impacted outcomes (P\u0026thinsp;=\u0026thinsp;0.006), while Immunoglobulins had a positive effect (0.019). Biomarkers including CRP, GPT, BUN, and creatinine were all found to be correlated with death, with elevated values indicating higher mortality risk (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Finally, Mechanical ventilation was associated with higher mortality rates (P\u0026thinsp;=\u0026thinsp;0.008).\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThis study provides significant contributions to our understanding of COVID-19 in children, particularly in terms of clinical and neurological aspects, risk factors, and prognosis. The findings emphasize the importance of early detection, monitoring of biomarkers, and the incorporation of these insights into healthcare policies. By recognizing the unique challenges and implications of COVID-19 in pediatric patients, healthcare providers can enhance patient care and optimize outcomes in the midst of the ongoing pandemic.\u003c/p\u003e","manuscriptTitle":"Neurological Complications, Mortality Risk Factors, and Prognosis in Pediatric COVID-19 Patients: Insights from a Three-Year Prospective Study at the University Children’s Hospital in Damascus.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-28 17:00:55","doi":"10.21203/rs.3.rs-4557613/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2fef57b3-69ab-4209-9e7a-37eba9d8e25c","owner":[],"postedDate":"June 28th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-07-08T03:39:52+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-28 17:00:55","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4557613","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4557613","identity":"rs-4557613","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}