{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:41:18Z","timestamp":1790790078957,"version":"4.1.0"},"reference-count":45,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Neurological manifestations during acute SARS-CoV-2\u2013related multisystem inflammatory syndrome in children (MIS-C) are common in hospitalized patients younger than 18 years and may increase risk of new neurocognitive or functional morbidity.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess the association of severe neurological manifestations during a SARS-CoV-2\u2013related hospital admission with new neurocognitive or functional morbidities at discharge.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This prospective cohort study from 46 centers in 10 countries included patients younger than 18 years who were hospitalized for acute SARS-CoV-2 or MIS-C between January 2, 2020, and July 31, 2021.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Severe neurological manifestations, which included acute encephalopathy, seizures or status epilepticus, meningitis or encephalitis, sympathetic storming or dysautonomia, cardiac arrest, coma, delirium, and stroke.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was new neurocognitive (based on the Pediatric Cerebral Performance Category scale) and\/or functional (based on the Functional Status Scale) morbidity at hospital discharge. Multivariable logistic regression analyses were performed to examine the association of severe neurological manifestations with new morbidity in each SARS-CoV-2\u2013related condition.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Overall, 3568 patients younger than 18 years (median age, 8 years [IQR, 1-14 years]; 54.3% male) were included in this study. Most (2980 [83.5%]) had acute SARS-CoV-2; the remainder (588 [16.5%]) had MIS-C. Among the patients with acute SARS-CoV-2, 536 (18.0%) had a severe neurological manifestation during hospitalization, as did 146 patients with MIS-C (24.8%). Among survivors with acute SARS-CoV-2, those with severe neurological manifestations were more likely to have new neurocognitive or functional morbidity at hospital discharge compared with those without severe neurological manifestations (27.7% [n\u2009=\u2009142] vs 14.6% [n\u2009=\u2009356];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). For survivors with MIS-C, 28.0% (n\u2009=\u200939) with severe neurological manifestations had new neurocognitive and\/or functional morbidity at hospital discharge compared with 15.5% (n\u2009=\u200968) of those without severe neurological manifestations (\n P<\/jats:italic>\n \u2009=\u2009.002). When adjusting for risk factors in those with severe neurological manifestations, both patients with acute SARS-CoV-2 (odds ratio, 1.85 [95% CI, 1.27-2.70];\n P<\/jats:italic>\n \u2009=\u2009.001) and those with MIS-C (odds ratio, 2.18 [95% CI, 1.22-3.89];\n P<\/jats:italic>\n \u2009=\u2009.009) had higher odds of having new neurocognitive and\/or functional morbidity at hospital discharge.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The results of this study suggest that children and adolescents with acute SARS-CoV-2 or MIS-C and severe neurological manifestations may be at high risk for long-term impairment and may benefit from screening and early intervention to assist recovery.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.14122","type":"journal-article","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T11:04:44Z","timestamp":1718017484000},"page":"e2414122","source":"Crossref","is-referenced-by-count":21,"title":["Severe Pediatric Neurological Manifestations With SARS-CoV-2 or MIS-C Hospitalization and New Morbidity"],"prefix":"10.1001","volume":"7","author":[{"given":"Conall","family":"Francoeur","sequence":"first","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Department of Pediatrics, Montreal Children\u2019s Hospital, McGill University Health Center, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia M.","family":"Alcamo","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"},{"name":"Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney L.","family":"Robertson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S.","family":"Wainwright","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, University of Washington, Seattle Children\u2019s Hospital, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan D.","family":"Roa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Universidad Nacional de Colombia, Bogot\u00e1, Colombia"},{"name":"Department of Pediatric Neurology, Faculty of Medicine, Fundaci\u00f3n Universitaria de Ciencias de la Salud, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlina E.","family":"Lovett","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children\u2019s Hospital, The Ohio State University, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey","family":"Stulce","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mais","family":"Yacoub","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Department of Pediatrics, University Medical Center Children\u2019s Hospital, Las Vegas, Nevada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renee M.","family":"Potera","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Zivick","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Department of Pediatrics, Medical University of South Carolina, Charleston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Holloway","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Department of Pediatrics, University of Maryland Medical Center, Baltimore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Nagpal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Critical Care Medicine, Oklahoma Children\u2019s Hospital at Oklahoma University Health, College of Medicine, The University of Oklahoma Health Sciences, Oklahoma City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari","family":"Wellnitz","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care, Department of Pediatrics, Carver College of Medicine, University of Iowa Health Care, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katelyn M.","family":"Even","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Penn State College of Medicine, The Pennsylvania State University, Hershey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werther","family":"Brunow de Carvalho","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isadora S.","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie P.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of North Carolina at Chapel Hill Hospitals, Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracie C.","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of North Carolina at Chapel Hill Hospitals, Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Campos-Mi\u00f1o","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Hospital Metropolitano, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie A.","family":"Dervan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew S.","family":"Geneslaw","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care and Hospital Medicine, Department of Pediatrics, Columbia University Irving Medical Center, New York, New 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