{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T01:38:21Z","timestamp":1786757901307,"version":"build-2736575974"},"reference-count":16,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2023,1,1]]},"abstract":"<jats:sec id=\"ab-nbr220007-4\"><jats:title>Importance<\/jats:title><jats:p>In 2020 during the COVID-19 pandemic, neurologic involvement was common in children and adolescents hospitalized in the United States for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)\u2013related complications.<\/jats:p><\/jats:sec><jats:sec id=\"ab-nbr220007-5\"><jats:title>Objective<\/jats:title><jats:p>To provide an update on the spectrum of SARS-CoV-2\u2013related neurologic involvement among children and adolescents in 2021.<\/jats:p><\/jats:sec><jats:sec id=\"ab-nbr220007-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>Case series investigation of patients reported to public health surveillance hospitalized with SARS-CoV-2\u2013related illness between December 15, 2020, and December 31, 2021, in 55 US hospitals in 31 states with follow-up at hospital discharge. A total of 2253 patients were enrolled during the investigation period. Patients suspected of having multisystem inflammatory syndrome in children (MIS-C) who did not meet criteria (n\u2009=\u200985) were excluded. Patients (&amp;amp;lt;21 years) with positive SARS-CoV-2 test results (reverse transcriptase\u2013polymerase chain reaction and\/or antibody) meeting criteria for MIS-C or acute COVID-19 were included in the analysis.<\/jats:p><\/jats:sec><jats:sec id=\"ab-nbr220007-7\"><jats:title>Exposure<\/jats:title><jats:p>SARS-CoV-2 infection.<\/jats:p><\/jats:sec><jats:sec id=\"ab-nbr220007-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Patients with neurologic involvement had acute neurologic signs, symptoms, or diseases on presentation or during hospitalization. Life-threatening neurologic involvement was adjudicated by experts based on clinical and\/or neuroradiological features. Type and severity of neurologic involvement, laboratory and imaging data, vaccination status, and hospital discharge outcomes (death or survival with new neurologic deficits).<\/jats:p><\/jats:sec><jats:sec id=\"ab-nbr220007-9\"><jats:title>Results<\/jats:title><jats:p>Of 2168 patients included (58% male; median age, 10.3 years), 1435 (66%) met criteria for MIS-C, and 476 (22%) had documented neurologic involvement. Patients with neurologic involvement vs without were older (median age, 12 vs 10 years) and more frequently had underlying neurologic disorders (107 of 476 [22%] vs 240 of 1692 [14%]). Among those with neurologic involvement, 42 (9%) developed acute SARS-CoV-2\u2013related life-threatening conditions, including central nervous system infection\/demyelination (n\u2009=\u200923; 15 with possible\/confirmed encephalitis, 6 meningitis, 1 transverse myelitis, 1 nonhemorrhagic leukoencephalopathy), stroke (n\u2009=\u200911), severe encephalopathy (n\u2009=\u20095), acute fulminant cerebral edema (n\u2009=\u20092), and Guillain-Barr\u00e9 syndrome (n\u2009=\u20091). Ten of 42 (24%) survived with new neurologic deficits at discharge and 8 (19%) died. Among patients with life-threatening neurologic conditions, 15 of 16 vaccine-eligible patients (94%) were unvaccinated.<\/jats:p><\/jats:sec><jats:sec id=\"ab-nbr220007-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>SARS-CoV-2\u2013related neurologic involvement persisted in US children and adolescents hospitalized for COVID-19 or MIS-C in 2021 and was again mostly transient. Central nervous system infection\/demyelination accounted for a higher proportion of life-threatening conditions, and most vaccine-eligible patients were unvaccinated. COVID-19 vaccination may prevent some SARS-CoV-2\u2013related neurologic complications and merits further study.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaneurol.2022.3881","type":"journal-article","created":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T16:00:55Z","timestamp":1667836855000},"page":"91","source":"Crossref","is-referenced-by-count":27,"title":["Changes in Distribution of Severe Neurologic Involvement in US Pediatric Inpatients With COVID-19 or Multisystem Inflammatory Syndrome in Children in 2021 vs 2020"],"prefix":"10.1001","volume":"80","author":[{"given":"Kerri L.","family":"LaRovere","sequence":"first","affiliation":[{"name":"Department of Neurology, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina Y.","family":"Poussaint","sequence":"additional","affiliation":[{"name":"Department of Radiology, Boston Children\u2019s Hospital, Boston, 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