Characteristics, Prevalence and Risk Factors of Neurologic Manifestations in Hospitalized Children Diagnosed With Acute SARS-CoV-2 and MIS-C in Indonesia.

Background: The COVID-19 pandemic is a prevalent condition caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several studies have shown that affected patients can experience neurologic manifestations. This study aims to analyze the frequency, early impact and risk factors for neurologic manifestations in hospitalized children with acute SARS-CoV-2 infection or multisystem inflammatory syndrome in children (MIS-C).

Methods: This is a multicenter, cross-sectional study of neurologic manifestations in children who were hospitalized with positive SARS-CoV-2 test or clinical diagnosis of SARS-CoV-2-related condition and MIS-C between June 2020 and June 2023. Multivariable logistic regression was carried out to identify the risk factors for neurologic manifestations.

Results: Among the 1397 children analyzed, 1283 (91.8%) and 114 (8.2%) were diagnosed with acute SARS-CoV-2 and MIS-C, respectively. The results showed that neurologic manifestations occurred in 51.2% of patients, with seizures (26.3%) and acute encephalopathy (17.5%) being the most common in the overall cohort. A total of 25% of children received ICU care, where patients with acute SARS Co-V-2 and nonneurologic manifestations were more admitted to ICU compared with those suffering from MIS-C and neurologic manifestations ( P < 0.0001). The overall mortality in this study was 16.1%, and most deaths were observed in patients with neurologic manifestations (26.3%). Based on the multivariable logistic regression in the overall cohort, younger age, fever, anorexia, and preexisting neurology, respiratory and renal urology conditions were associated with neurologic manifestations ( P < 0.05).

Conclusions: The results showed that neurologic manifestations were common among children hospitalized with acute SARS-CoV-2 and MIS-C.