Evidence map›Paper›PMID 38857050›Full record

ArticleJAMA network open2024

Severe Pediatric Neurological Manifestations With SARS-CoV-2 or MIS-C Hospitalization and New Morbidity.

Conall Francoeur, Alicia M Alcamo, Courtney L Robertson, Mark S Wainwright, Juan D Roa, Marlina E Lovett, Casey Stulce, Mais Yacoub, Renee M Potera, Elizabeth Zivick and 69 more

Erratum issuedAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
  3. Review
  4. Review
  5. Article
  6. Article
  7. MIS-C: Diagnosis, Management, and Outcomes.Open forum infectious diseases · 2026
    Review
  8. Article
  9. Article
  10. Article
  11. Review
  12. Article
  13. Byline Errors.JAMA network open · 2024
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

79 authors.

Conall FrancoeurDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
Alicia M AlcamoDivision of Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Courtney L RobertsonDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Mark S WainwrightDivision of Pediatric Neurology, University of Washington, Seattle Children's Hospital, Seattle.
Juan D RoaDepartment of Pediatrics, Universidad Nacional de Colombia, Bogotá, Colombia.
Marlina E LovettDivision of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus.
Casey StulceDepartment of Pediatrics, The University of Chicago, Chicago, Illinois.
Mais YacoubDivision of Critical Care, Department of Pediatrics, University Medical Center Children's Hospital, Las Vegas, Nevada.
Renee M PoteraDepartment of Pediatrics, The University of Texas Southwestern Medical Center, Dallas.
Elizabeth ZivickDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Medical University of South Carolina, Charleston.
Adrian HollowayDivision of Critical Care, Department of Pediatrics, University of Maryland Medical Center, Baltimore.
Ashish NagpalDepartment of Pediatrics, Section of Critical Care Medicine, Oklahoma Children's Hospital at Oklahoma University Health, College of Medicine, The University of Oklahoma Health Sciences, Oklahoma City.
Kari WellnitzDivision of Pediatric Critical Care, Department of Pediatrics, Carver College of Medicine, University of Iowa Health Care, Iowa City.
Katelyn M EvenDivision of Pediatric Critical Care Medicine, Penn State College of Medicine, The Pennsylvania State University, Hershey.
Werther Brunow de CarvalhoDepartment of Pediatrics, University of São Paulo, São Paulo, Brazil.
Isadora S RodriguezDepartment of Pediatrics, University of São Paulo, São Paulo, Brazil.
Stephanie P SchwartzDepartment of Pediatrics, University of North Carolina at Chapel Hill Hospitals, Chapel Hill.
Tracie C WalkerDepartment of Pediatrics, University of North Carolina at Chapel Hill Hospitals, Chapel Hill.
Santiago Campos-MiñoPediatric Intensive Care Unit, Hospital Metropolitano, Quito, Ecuador.
Leslie A DervanDivision of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle.
Andrew S GeneslawDivision of Pediatric Critical Care and Hospital Medicine, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.
Taylor B SewellDivision of Pediatric Critical Care and Hospital Medicine, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.
Patrice PryceDivision of Pediatric Critical Care and Hospital Medicine, Department of Pediatrics, Columbia University Irving Medical Center, New York-Presbyterian Morgan Stanley Children's Hospital, New York, New York.
Wendy G SilverDivision of Child Neurology, Department of Neurology, Columbia University Irving Medical Center, New York, New York.
Jieru E LinDivision of Child Neurology, Department of Neurology, Columbia University Irving Medical Center, New York, New York.
Wendy S VargasDivision of Child Neurology, Department of Neurology, Columbia University Irving Medical Center, New York, New York.
Alexis TopjianDivision of Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Jennifer L McGuireDepartment of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia.
Jesus Angel Domínguez RojasDivision of Pediatric Critical Care, Department of Pediatrics, Hospital de Emergencia Villa El Salvador, Lima, Peru.
Jaime Tasayco-MuñozDivision of Pediatric Critical Care, Department of Pediatrics, Hospital de Emergencia Villa El Salvador, Lima, Peru.
Sue J HongDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
William J MullerDepartment of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Matthew DoerflerDepartment of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Cydni N WilliamsPediatric Critical Care and Neurotrauma Recovery Program, Department of Pediatrics, Oregon Health & Science University, Portland.
Kurt DruryDivision of Pediatric Critical Care, Department of Pediatrics, Oregon Health & Science University, Portland.
Dhristie BhagatDepartment of Neurology, New York University Langone Health, New York.
Aaron NelsonDepartment of Neurology, New York University Langone Health, New York.
Dana PriceDepartment of Neurology, New York University Langone Health, New York.
Heda DapulDivision of Pediatric Critical Care, Department of Pediatrics, Hassenfeld Children's Hospital, New York University Langone Health, New York.
Laura SantosDivision of Pediatric Critical Care, Department of Pediatrics, Hassenfeld Children's Hospital, New York University Langone Health, New York.
Robert KahoudDivision of Pediatric Critical Care Medicine, Department of Pediatrics and Adolescent Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
Brian AppavuDivision of Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, The University of Arizona, College of Medicine, Phoenix.
Kristin P GuilliamsDepartment of Neurology, Washington University School of Medicine in St Louis, St Louis, Missouri.
Shannon C AgnerDepartment of Neurology, Washington University School of Medicine in St Louis, St Louis, Missouri.
Karen H WalsonDivision of Pediatric Critical Care Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia.
Lindsey RasmussenDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Standford University Medicine, Lucile Packard Children's Hospital Stanford, Stanford, California.
Ria PalSafar Center for Resuscitation Research, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
Anna JanasDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Standford University Medicine, Lucile Packard Children's Hospital Stanford, Stanford, California.
Peter FerrazzanoDepartment of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison.
Raquel Farias-MoellerDivision of Child Neurology, Department of Neurology, Medical College of Wisconsin, Children's Wisconsin, Milwaukee.
Kellie C SnooksDepartment of Pediatrics, Medical College of Wisconsin, Children's Wisconsin, Milwaukee.
Chung-Chou H ChangDivision of Pediatric Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
Tomás IolsterDepartment of Pediatrics, Hospital Universitario Austral, Buenos Aires, Argentina.
Jennifer C ErklauerDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston.
Facundo Jorro BaronDepartment of Pediatrics, Hospital General de Niños Pedro Elizade, Buenos Aires, Argentina.
Evangeline WassmerBirmingham Children's Hospital, Birmingham, United Kingdom.
Michael YoongDepartment of Neurology, Royal London Children's Hospital, London, United Kingdom.
Michelle JardinePediatric Critical Care Unit, University Hospital of Wales, Cardiff, United Kingdom.
Zoha MohammadPediatric Intensive Care Unit, University Hospitals Leicester NHS Trust, Leicester, United Kingdom.
Akash DeepDepartment of Women and Children's Health, King's College Hospital, London, United Kingdom.
Tanil KendirliDepartment of Pediatric Critical Care Medicine, Ankara University School of Medicine, Ankara, Turkey.
Karen LidskyDivision of Pediatric Critical Care Medicine, Wolfson Children's Hospital, Jacksonville, Florida.
Samantha DallefeldDepartment of Pediatrics, Dell Children's Hospital, Austin, Texas.
Helen FlocktonPaediatric Critical Care Unit, Oxford University Hospitals, Oxford, United Kingdom.
Shruti AgrawalPaediatric Intensive Care Unit, Cambridge University Hospitals, Cambridge, United Kingdom.
Krishna Sumanth SiruguppaDivision of Pediatric Critical Care, Department of Pediatrics, University of California, San Francisco.
Michaela WaakChild Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
Alfonso Gutiérrez-MataDepartment of Pediatric Neurology, Dr. Carlos Sáenz Herrera National Children's Hospital, San José, Costa Rica.
Warwick ButtDepartment of Critical Care, Melbourne Medical School, The University of Melbourne, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.
Sixto Bogantes-LedezmaDepartment of Pediatric Neurology, Dr. Carlos Sáenz Herrera National Children's Hospital, San José, Costa Rica.
Fabricio Sevilla-AcostaDepartment of Pediatrics, La Anexión Hospital, Guanacaste, Costa Rica.
Andres Umaña-CalderónDepartment of Pediatric Neurology, Dr. Carlos Sáenz Herrera National Children's Hospital, San José, Costa Rica.
Adriana Ulate-CamposDepartment of Pediatric Neurology, Dr. Carlos Sáenz Herrera National Children's Hospital, San José, Costa Rica.
Adriana Yock-CorralesDepartment of Emergency Service, Dr. Carlos Sáenz Herrera National Children's Hospital, San José, Costa Rica.
Victor Brodzik TalisaDivision of Pediatric Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
Hari Krishnan KanthimathinathanWest Midlands Regional Genetics Laboratory, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom.
Michelle E SchoberDivision of Critical Care, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City.
Ericka L FinkDivision of Pediatric Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
Global Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID) Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Neurological manifestations during acute SARS-CoV-2-related 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. Objective: To assess the association of severe neurological manifestations during a SARS-CoV-2-related hospital admission with new neurocognitive or functional morbidities at discharge. Design, Setting, and Participants: 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. Exposure: Severe neurological manifestations, which included acute encephalopathy, seizures or status epilepticus, meningitis or encephalitis, sympathetic storming or dysautonomia, cardiac arrest, coma, delirium, and stroke. Main Outcomes and Measures: 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-related condition. Results: 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 = 142] vs 14.6% [n = 356]; P < .001). For survivors with MIS-C, 28.0% (n = 39) with severe neurological manifestations had new neurocognitive and/or functional morbidity at hospital discharge compared with 15.5% (n = 68) of those without severe neurological manifestations (P = .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]; P = .001) and those with MIS-C (odds ratio, 2.18 [95% CI, 1.22-3.89]; P = .009) had higher odds of having new neurocognitive and/or functional morbidity at hospital discharge. Conclusions and Relevance: 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.

Indexed as

COVID-19HospitalizationNervous System DiseasesSARS-CoV-2Systemic Inflammatory Response SyndromeAdolescentChildChild, PreschoolFemaleHumansInfantMaleProspective StudiesSeverity of Illness Index

Identifiers

PMID38857050
PMCPMC11165382

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