Neurological Manifestations in Pediatric COVID-19 Patients Hospitalized at King Abdulaziz University Hospital, Jeddah, Saudi Arabia: A Retrospective Study
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Design and Setting
2.2. COVID-19 Diagnosis
2.3. Data Collection
2.4. Data Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Number | % |
---|---|---|
Gender, females | 48 | 51.1% |
Main presenting complaint (symptoms at initial presentation) Fever Respiratory symptoms Fever and Respiratory symptoms Gastrointestinal symptoms Fever and neurological symptoms Fever and Gastrointestinal symptoms | 24 21 19 10 8 7 | 25.5% 22.3% 20.2% 10.6% 8.5% 7.4% |
History of exposure to positive COVID-19 | 52 | 55.3% |
Family member with positive COVID-19 | 45 | 47.9% |
Place of admission Ward PICU | 84 10 | 89.4% 10.6% |
Comorbidities Hematologic Cardiac Renal Undernutrition Leukemia Diabetes mellitus Chronic diarrhea Bronchial asthma Cystic fibrosis Immunodeficiency Epilepsy Cerebral palsy GBS Neurodegenerative disease Nephrotic syndrome | 33 9 4 4 2 2 2 2 1 1 1 1 1 1 1 1 | 35.1% 9.6% 4.3% 4.3% 2.1% 2.1% 2.1% 2.1% 1.1% 1.1% 1.1% 1.1% 1.1% 1.1% 1.1% 1.1% |
Outcome Survived Died | 91 3 | 96.8% 3.2% |
Variables | Measured Values | Variables by Category * | |
---|---|---|---|
N% | |||
Total WBCs (×103/mm3) | (Median, IQR) 7.9 (5.4–12.3) | Normal WBC count Leukopenia Leukocytosis | 70→8 16→74.5 8.5→17.0 |
Neutrophils(×103/mm3) | (Median, IQR) 3.9 (2.3–7.4) | Normal neutrophil count Neutropenia Neutrophilia | 77→81.9 12→12.8 5→5.3 |
Lymphocytes (×103/mm3) | (Median, IQR) 2.4 (1.4–4.3) | Normal lymphocyte count Lymphopenia | 62→66.0 32→34.0 |
RBCs (×106/mm3) | (Mean ± SD, Range) 4.2 ± 0.97 (1,250,000–6,550,000) | Normal RBC count Anemia Polycythemia | 56→59.6 34→36.2 4→4.3 |
Hemoglobin (g/dL) | (Mean ± SD, Range) 11.27 ± 2.59 (3.40–18.50) | Normal hemoglobin Low hemoglobin (anemia) High hemoglobin (polycythemia) | 51→54.3 38→40.4 5→5.3 |
Platelet count (×103/mm3) | (Median, IQR) 287 (211–382) | Normal platelet count Thrombocytopenia Thrombocytosis | 81→86.2 7→7.4 6→6.4 |
CRP (mg/dL) | (Median, IQR) 3.74 (3.0–9.8) | Normal High | 66→70.2 28→29.8 |
Ferritin (ng/mL) | (Median, IQR) 100 (74.5–123.8) | Normal High | 75→79.8 19→20.2 |
D-dimer (mg/L) | (Median, IQR) 0.34 (0.24–0.66) | Normal High | 61→63.8 33→36.2 |
INR | (Mean ± SD, Range) 1.10 ± 0.22 (0.90–2.38) | Normal High | 84→89.4 10→10.6 |
APTT Seconds | (Mean ± SD, Range) 37.38 ± 7.65 (23.0–60.0) | Normal High | 89→94.7 5→5.3 |
ALT (U/L) | (Median, IQR) 32 (25–45) | Normal High | 78→83.0 16→17.0 |
AST (U/L) | (Median, IQR) 8 (22–34) | Normal High | 65→69.1 29→30.9 |
Total serum bilirubin (umol/L) | (Median, IQR) 7.0 (5.0–11.0) | Normal High | 82→87.2 12→12.8 |
Serum Albumin (gm/L) | (Mean ± SD, Range) 38.3 (4–55.4) | Normal High | 82→87.2 12→12.8 |
BUN (mmol/L) | (Median, IQR) 3.5 (2.8–4.5) | Normal High | 84→89.4 10→10.6 |
Serum creatinine (µmol/L) | (Median, IQR) 34 (22–50.3) | Normal High | 80→85.1 14→14.9 |
Variables | COVID-19 Cases without Neurologic Manifestations N = 65 N% | COVID-19 Cases with Neurologic Manifestations N = 29 N% | Significance p-Value |
---|---|---|---|
Gender Male Female | 33→50.8 32→49.2 | 13→44.8 16→55.2 | 0.60 a |
Nationality Saudi Non-Saudi | 31→47.7 34→52.3 | 10→34.5 19→65.5 | 0.23 a |
Main initial presentation Asymptomatic Symptoms at initial presentation Fever Respiratory symptoms Fever and Respiratory symptoms Gastrointestinal symptoms Fever and neurological symptoms Fever and Gastrointestinal symptoms | 5→7.7 60→92.3 18→27.7 15→23.1 14→21.4 8→12.3 0→0 5→7.7 | 0→0 29→100 6→20.7 6→20.7 5→17.2 2→6.9 8→27.6 2→6.9 | NA |
History of exposure to SARS-CoV2 Yes No | 27→41.5 38→58.5 | 15→51.7 14→48.3 | 0.36 a |
Family member with positive SARS-CoV2 infection Yes No | 33→50.8 32→49.2 | 16→55.2 13→44.8 | 0.96 a |
Comorbidities (risk factors for severe COVID-19) Yes No | 24→36.9 41→63.1 | 9→31.0 20→69.0 | 0.58 a |
Place of admission Inpatient ward PICU | 60→92.3 5→7.7 | 24→82.8 5→17.2 | 0.17 a |
Outcome Survived Died | 64→98.5 1→1.5 | 27→93.1 2→6.9 | 0.17 a |
Variables (Measured Value) | COVID-19 Cases without Neurologic Manifestations N = 65 | COVID-19 Cases with Neurologic Manifestations N = 29 | Significance p-Value |
---|---|---|---|
Red blood cells (Mean ±SD), range (×106/mm3) | 3.99 ± 1.0 (1.25–5.74) | 4.5 ± 0.80 (2.56–6.55) | 0.02 * a |
Hemoglobin (HB) (Mean ± SD), (gm/dL) | 10.92 ± 2.71 (3.4–18.5) | 12.06 ± 2.14 (7.8–18.5) | 0.049 * a |
White blood cells (Median, IQR) (×103/mm3) | 7.96 (5.57–12.50) | 7.80 (5.12–11.45) | 0.44 b |
Neutrophils (Median, IQR) (×103/mm3) | 4.27 (2.28–7.46) | 3.29 (2.45–6.80) | 0.45 b |
Lymphocytes (Median, IQR) (×103/mm3) | 2.58 (1.42–4.66) | 2.35 (1.21–3.87) | 0.48 b |
Platelet count (Median, IQR) (×103/mm3) | 271 (206–387) | 299 (210–376) | 0.72 b |
CRP (Median, IQR) (mg/dL) | 4 (3–8.28) | 3.47 (3–21) | 0.83 b |
Ferritin (Median, IQR) (ng/mL) | 98 (71.5–120) | 100 (81–154.75) | 0.39 b |
D-dimer (Median, IQR) ug/mL | 0.34 (0.27–0.63) | 0.41 (0.20–0.73) | 0.90 b |
INR (Mean ± SD) | 1.10 ± 0.25 (0.90–2.38) | 1.07 ± 0.13 (0.90–1.40) | 0.97 a |
APTT (Mean ± SD) Seconds | 36.22 ± 7.27 (23–60) | 40.0 ± 7.95 (29.0–58.0) | 0.03 * a |
Alanine aminotransferase (Median, IQR) (U/L) | 28 (24–34) | 29 (18–53) | 0.73 b |
Aspartate aminotransferase (Median, IQR) (U/L) | 33 (25–45) | 31 (22–51) | 0.46 b |
Total serum bilirubin (Median, IQR) (mg/dL) | 7 (5–12) | 6 (4–7.5) | 0.02 * b |
Serum albumin (Median, IQR) (gm/L) | 38.82 ± 7.41 (4–55.4) | 37.0 ± 6.2 (19.10–47.3) | 0.26 b |
BUN (Median, IQR) (mmol/L) | 3.40 (2.8–4.55) | 3.6 (2.7–4.35) | 0.74 b |
Serum creatinine (Median, IQR) (umol/L) | 34 (23–48) | 38 (22–57) | 0.49 b |
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Hegazi, M.A.; Saeedi, F.A.; Atwah, A.F.; Sayed, M.H.; Albeladi, A.A.; Alyoubi, S.B.; Aljudibi, R.A.; Alyaslami, S.M.; Alkathiry, A.T.; Abdelgalil, A.A. Neurological Manifestations in Pediatric COVID-19 Patients Hospitalized at King Abdulaziz University Hospital, Jeddah, Saudi Arabia: A Retrospective Study. Children 2022, 9, 1870. https://doi.org/10.3390/children9121870
Hegazi MA, Saeedi FA, Atwah AF, Sayed MH, Albeladi AA, Alyoubi SB, Aljudibi RA, Alyaslami SM, Alkathiry AT, Abdelgalil AA. Neurological Manifestations in Pediatric COVID-19 Patients Hospitalized at King Abdulaziz University Hospital, Jeddah, Saudi Arabia: A Retrospective Study. Children. 2022; 9(12):1870. https://doi.org/10.3390/children9121870
Chicago/Turabian StyleHegazi, Moustafa A., Fajr A. Saeedi, Ali F. Atwah, Mohamed H. Sayed, Asala A. Albeladi, Shahad B. Alyoubi, Razan A. Aljudibi, Shahad M. Alyaslami, Abdullah T. Alkathiry, and Abobakr A. Abdelgalil. 2022. "Neurological Manifestations in Pediatric COVID-19 Patients Hospitalized at King Abdulaziz University Hospital, Jeddah, Saudi Arabia: A Retrospective Study" Children 9, no. 12: 1870. https://doi.org/10.3390/children9121870
APA StyleHegazi, M. A., Saeedi, F. A., Atwah, A. F., Sayed, M. H., Albeladi, A. A., Alyoubi, S. B., Aljudibi, R. A., Alyaslami, S. M., Alkathiry, A. T., & Abdelgalil, A. A. (2022). Neurological Manifestations in Pediatric COVID-19 Patients Hospitalized at King Abdulaziz University Hospital, Jeddah, Saudi Arabia: A Retrospective Study. Children, 9(12), 1870. https://doi.org/10.3390/children9121870