Acute encephalopathy in childhood associated with COVID-19

Abstract

The number of pediatric patients with COVID-19 has increased rapidly since the omicron variant became the main cause of the disease. By November 2022, 103 cases of COVID-19-related acute encephalopathy had been reported. Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) was the most common syndrome (27 cases, 26.2%). There were 8 cases of hemorrhagic shock and encephalopathy syndrome (HSES), 6 cases of encephalopathy with acute fulminant cerebral edema (AFCE), and 4 cases of acute necrotizing encephalopathy (ANE); thus, in total, there were 18 cases (17.5%) of cytokine storm encephalopathy. The frequencies were higher than those reported in 2017 for ANE (2.8%) and HSES (1.7%), before COVID-19. The prognosis of COVID-19-related acute encephalopathy was poor (11 deaths, 10.7%) due to the high frequencies of HSES and AFCE, which have a severe course.