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. 2024 Jan 16;24(1):49.
doi: 10.1186/s12887-023-04496-y.

Clinical manifestations and EEG findings in children infected with COVID-19 and exhibiting neurological symptoms

Yue Yang #  1 , Tao Yu #  1 , Jie Yang  1 , Jia Luo  1 , Xuan Liu  1 , Chong Mu  1 , Xiaochuan Wang  1 , Yao Deng  1 , Rong Luo  2   3
Affiliations

Clinical manifestations and EEG findings in children infected with COVID-19 and exhibiting neurological symptoms

Yue Yang et al. BMC Pediatr. .

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection has many neurological manifestations, and its effects on the nervous system are increasingly recognized. There has been no systematic analysis of electroencephalography (EEG) characteristics in children exhibiting neurological symptoms of Coronavirus disease 2019 (COVID-19). The primary aim of this study was to describe the EEG characteristics caused by COVID-19 infection in children who were showing neurological symptoms and to assess the relationship between COVID-19-related EEG changes and clinical features in these children.

Method: This study included 125 pediatric patients infected with SARS-CoV2 and showing neurological symptoms, and their continuous EEG was recorded. In addition, the demographic and clinical characteristics of these patients were analyzed and the correlation between the two was investigated.

Results: Abnormal EEG findings were detected in 31.20% (N = 39) of the patients. Abnormal discharges (43.59%) were the most common EEG abnormalities, followed by background abnormalities (41.03%). The proportion of patients diagnosed with febrile seizure was higher in the normal EEG group than in the abnormal EEG group (P = 0.002), while the opposite was true for epilepsy and encephalitis/encephalopathy (P = 0.016 and P = 0.003, respectively). The independent associated factors of abnormal EEG were age and total length of stay (P < 0.001 and P = 0.003, respectively). Non-specific EEG abnormalities were found in COVID-19-related encephalitis/encephalopathy.

Conclusion: Our study corroborated that a small group of pediatric patients infected by COVID-19 and showing neurological symptoms may exhibit abnormal EEG. This study could help improve the understanding of clinical and EEG characteristics in children with COVID-19 and inform triage policies in other hospitals during the COVID-19 pandemic.

Keywords: COVID-19; EEG; Pediatrics; Seizures.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
EEGs of patients suffered from encephalitis/encephalopathy. All patients showed different degrees of EEG background wave slowing. A was from patient 1 and showed diffuse δ-θ slowing waves. B Was from patient 2 and showed diffuse δ slowing waves. Figure (C) was from patient 3 and showed diffuse δ slowing waves with a few α rhythms in the occipital region. Figure (D) was from patient 4 and showed diffuse θ slowing waves with a few δ slowing waves
Fig. 2
Fig. 2
Abnormal discharges of patients suffered from encephalitis/encephalopathy. A From Patient 1, the EEG showed sharp and slow wave discharges in the patient's (a) right occipital region and (b) left and right posterior temporal regions. B From Patient 4, EEG showed low amplitude α rhythmic discharges in the patient's (c) bilateral prefrontal, frontal, and (d) frontal midline regions
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