Prevalence and risk factors of pediatric seizures in COVID-19 infection: A study from Thailand.

Introduction: COVID-19 is an emerging disease primarily presenting with respiratory tract infections in children. Recent reports have highlighted neurological manifestations, including seizures. However, there is a lack of studies regarding the prevalence and risk factors for pediatric seizures associated with COVID-19 in Thailand. Methods: This retrospective study involved pediatric patients aged 1 month to 15 years who had clinical seizures as a primary symptom alongside COVID-19 infection. Patients diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C) were excluded. The study was conducted at Maharat Nakhon Ratchasima Hospital from December 1, 2019, to December 30, 2022. Demographic data were recorded. The prevalence of seizures and associated risk factors were evaluated. Results: A total of 963 pediatric patients were included in the study, with ages ranging from 1 month to 15 years. The mean age was 6.8 years (± 4.6 SD), with a male predominance (53.2 % male, 46.8 % female). Among these, 40 cases presented with clinical seizures, resulting in a seizure prevalence of 0.76. In the seizure group, ages ranged from 8 months to 14 years, with a mean age of 3.67 years (± 3.45 SD). This group also exhibited male predominance. Notably, 0.76 % of the patients were under the age of 5 years, and the majority (95 %) experienced febrile seizures associated with the Omicron variant. The identified risk factors for seizures included younger age (less than 5 years) and the severity of COVID-19 infection. A 2-year follow-up review indicated favorable neurodevelopmental outcomes. Conclusion: The prevalence of seizures in pediatric patients with COVID-19 varied according to the viral variant, with the Omicron variant being associated with a surge in febrile seizures. Younger age and the severity of COVID-19 were found to increase the risk of seizure occurrence.