Clinical characteristics and prognosis in 12 children with SARS-CoV-2 Omicron variant infection-associated acute necrotizing encephalopathy

SHEN Jin-Mei, LIU Rui-Hai, LI Zi-Pu, DONG Jian-Hong, TONG Jian-Ning, LI Jing

Chinese Journal of Contemporary Pediatrics ›› 2023, Vol. 25 ›› Issue (11) : 1170-1174.

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Chinese Journal of Contemporary Pediatrics ›› 2023, Vol. 25 ›› Issue (11) : 1170-1174. DOI: 10.7499/j.issn.1008-8830.2307058
CLINICAL RESEARCH

Clinical characteristics and prognosis in 12 children with SARS-CoV-2 Omicron variant infection-associated acute necrotizing encephalopathy

  • SHEN Jin-Mei, LIU Rui-Hai, LI Zi-Pu, DONG Jian-Hong, TONG Jian-Ning, LI Jing
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Abstract

Objective To study the clinical characteristics and prognosis of SARS-CoV-2 Omicron variant infection-associated acute necrotizing encephalopathy (ANE) in children. Methods A retrospective analysis was conducted on the medical data of 12 children with SARS-CoV-2 Omicron variant infection-associated ANE who were admitted to the Pediatric Intensive Care Unit, Qingdao Women and Children′s Hospital from December 18 to 29, 2022. The children were divided into two groups based on outcomes: death group (7 cases) and survival group (5 cases). The clinical manifestations and auxiliary examination results were compared between the two groups. Results The median age of the 12 patients was 30 months, with a male-to-female ratio of 1:1. All patients presented with persistent high fever, with a median highest body temperature of 41℃. The median time from fever onset to seizure or consciousness disturbance was 18 hours. The death group had a higher proportion of neurogenic shock, coagulation dysfunction, as well as elevated lactate, D-dimer, interleukin-6, interleukin--8, and interleukin-10 levels compared to the survival group (P<0.05). Conclusions Children with SARS-CoV-2 Omicron variant infection-associated with ANE commonly present with persistent high fever, rapidly progressing disease, and have a high likelihood of developing consciousness disorders and multiorgan dysfunction within a short period. The occurrence of neurogenic shock, coagulation dysfunction, and significantly elevated cytokine levels suggests an increased risk of mortality.

Key words

Acute necrotizing encephalopathy / SARS-CoV-2 infection / Omicron variant / Prognosis / Child

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SHEN Jin-Mei, LIU Rui-Hai, LI Zi-Pu, DONG Jian-Hong, TONG Jian-Ning, LI Jing. Clinical characteristics and prognosis in 12 children with SARS-CoV-2 Omicron variant infection-associated acute necrotizing encephalopathy[J]. Chinese Journal of Contemporary Pediatrics. 2023, 25(11): 1170-1174 https://doi.org/10.7499/j.issn.1008-8830.2307058

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