Abstract
BACKGROUND: The neurological symptoms caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are of increasing concern. Convulsions are among the main neurological manifestations reported in children with coronavirus disease-2019 (COVID-19), and cause serious harm to physical and mental health. This study aimed to investigate the risk factors for convulsion in children with COVID-19. METHODS: This prospective study was conducted at the Children's Hospital of Soochow University. In total, 102 COVID-19 patients with convulsion, 172 COVID-19 patients without convulsion, and 50 healthy controls were enrolled in the study. The children's clinical and laboratory data were analyzed to assess the risk factors for convulsion in COVID-19 patients. RESULTS: Convulsions occurred in 37.2% of children, mostly those aged 1-3 years, who were hospitalized with the Omicron variant. The neutrophil count, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume-to-platelet ratio (MPR) were significantly higher in the convulsion group than those in the non-convulsion and control groups (P < 0.01). However, the counts of lymphocytes, eosinophils, platelets, lymphocyte subsets, CD3(+) T cells, CD4(+) T cells, CD8(+) T cells, and NK cells were lower in the convulsion group than those in the non-convulsion and control groups (P < 0.01). Multivariate regression analysis indicated that NK cell count (OR = 0.081, 95% CI: 0.010-0.652) and a history of febrile seizure (OR = 10.359, 95% CI: 2.115-50.746) were independent risk factors for the appearance of convulsions in COVID-19. CONCLUSIONS: History of febrile seizure and decreased NK cell count were high-risk factors for convulsions in COVID-19 patients.