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Background/Objective <p>The aims of this study were to describe pediatric delirium and its association with inflammatory, neurodiagnostic, and clinical severity profiles in children hospitalized with acute coronavirus disease 2019 (COVID-19) infection or multisystem inflammatory syndrome in children (MIS-C).</p> Methods <p>We performed a secondary analysis of a multicenter, prospective observational cohort study including hospitalized children (&lt; 18&#xa0;years) with confirmed acute COVID-19 infection or MIS-C enrolled between 1 January 2020 and 31 July 2021 at 46 hospitals across ten countries participating in the Global Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID).</p> Results <p>Among 3211 patients, 57 (1.8%) had documented delirium. Delirium was more common in MIS-C than in acute COVID-19 (3.6% vs. 1.5%, <i>p</i> = 0.004). Children with delirium had higher inflammatory markers (e.g., C-reactive protein, ferritin, D-dimer, procalcitonin) and more frequently presented with severe neurologic manifestations (all <i>p</i> &lt; 0.001). Patients with delirium underwent more neurodiagnostic testing (<i>p</i> &lt; 0.001). Among children with delirium who received electroencephalogram (EEG) testing, abnormalities were universal (<i>n</i> = 23). Delirium was associated with longer hospital stays (median 17 vs. 4&#xa0;days; <i>p</i> &lt; 0.001), higher mortality (7.5% vs. 1.1%; <i>p</i> = 0.01), and worse functional outcomes, including higher rates of new disability at discharge as assessed by Pediatric Cerebral Performance Category (PCPC; 22.5% vs. 1.7%, <i>p</i> &lt; 0.001) and functional status scale (FSS; 22.7% vs. 2.1%, <i>p</i> = 0.001).</p> Conclusions <p>Delirium in a select group of patients with pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related illness was associated with systemic inflammation, severe neurologic injury, and worse clinical outcomes in a multicenter cohort. These findings underscore the importance of routine delirium screening and intervention in children hospitalized with SARS-CoV-2-related illnesses and other inflammatory conditions.</p>

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Delirium in Children Hospitalized with Acute COVID-19 or MIS-C: Secondary Analysis of the 2020–2021 Global Consortium Study of Neurologic Dysfunction in COVID-19

  • 期刊论文

  • 发表日期：

    2026年4月6日

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  • Neelima K. Marupudi,
  • Diana Paola Escobar-Serna,
  • Leslie Dervan,
  • Anna Janas,
  • Andrew S. Geneslaw,
  • Ericka L. Fink,
  • Juan David Roa Giraldo,
  • Marlina Lovett,
  • Shannon Agner,
  • Lindsey Rasmussen,
  • Karen Walson,
  • Alicia Alcamo,
  • Casey Stulce,
  • Santiago Campos-Miño,
  • Karen Lidsky,
  • Mais Yacoub,
  • Stephanie Schwartz,
  • Sue Hong,
  • Cydni Williams,
  • Ashish S. Nagpal,
  • Heda Dapul,
  • Kari Wellnitz,
  • Elizabeth Zivick,
  • Tomás Iolster,
  • Brian Appavu,
  • Courtney Robertson,
  • Jennifer Catherine Erklauer,
  • Katelyn Even,
  • Conall Francoeur,
  • Peter Ferrazzano,
  • Werther Brunow de Carvalho,
  • Adrian Holloway,
  • Jesus Dominguez,
  • Renee Potera,
  • Robert J. Kahoud,
  • Evangeline Wassmer,
  • Michael Yoong,
  • Michelle Jardine,
  • Zoha Mohammad,
  • Akash Deep,
  • Tanil Kendirli,
  • Hari Krishnan Kanthimathinathan,
  • Samantha Dallefeld,
  • Helen Flockton,
  • Shruti Agrawal,
  • Krishna Sumanth Siruguppa,
  • Michaela Waak,
  • Alfonso Gutierrez-Mata,
  • Warwick Butt,
  • Raquel Farias-Moeller,
  • Kellie Snooks,
  • Kristin Guilliams,
  • Ria Pal,
  • Jennifer Mcguire,
  • Alexis A. Topjian,
  • Adriana Ulate-Campos,
  • Tracie Walker,
  • Kurt Drury,
  • Laura Santos,
  • Facundo Jorro Barón,
  • Mark Wainwright,
  • Isadora Rodriguez,
  • Taylor Sewell,
  • Patrice Pryce,
  • Wendy Silver,
  • Jieru Lin,
  • Wendy Vargas,
  • Jaime Tasayco-Munoz,
  • William Muller,
  • Matthew Doerfler,
  • Dhristie Bhagat,
  • Aaron Nelson,
  • Dana Price,
  • Sixto Bogantes-Ledezma,
  • Fabricio Sevilla-Acosta,
  • Andres Umaña-Calderón,
  • Adriana Yock-Corrales,
  • Michelle Schober,
  • Jennifer Simmons,
  • Craig Smith,
  • Theresa Czech,
  • James J. Riviello,
  • Marianne Dufour,
  • Burak Balaban,
  • Michael Cronin,
  • Alyssa Serratore,
  • Darryl Miles,
  • Emily Davies Manzi Akande

摘要

Background/Objective

The aims of this study were to describe pediatric delirium and its association with inflammatory, neurodiagnostic, and clinical severity profiles in children hospitalized with acute coronavirus disease 2019 (COVID-19) infection or multisystem inflammatory syndrome in children (MIS-C).

Methods

We performed a secondary analysis of a multicenter, prospective observational cohort study including hospitalized children (< 18 years) with confirmed acute COVID-19 infection or MIS-C enrolled between 1 January 2020 and 31 July 2021 at 46 hospitals across ten countries participating in the Global Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID).

Results

Among 3211 patients, 57 (1.8%) had documented delirium. Delirium was more common in MIS-C than in acute COVID-19 (3.6% vs. 1.5%, p = 0.004). Children with delirium had higher inflammatory markers (e.g., C-reactive protein, ferritin, D-dimer, procalcitonin) and more frequently presented with severe neurologic manifestations (all p < 0.001). Patients with delirium underwent more neurodiagnostic testing (p < 0.001). Among children with delirium who received electroencephalogram (EEG) testing, abnormalities were universal (n = 23). Delirium was associated with longer hospital stays (median 17 vs. 4 days; p < 0.001), higher mortality (7.5% vs. 1.1%; p = 0.01), and worse functional outcomes, including higher rates of new disability at discharge as assessed by Pediatric Cerebral Performance Category (PCPC; 22.5% vs. 1.7%, p < 0.001) and functional status scale (FSS; 22.7% vs. 2.1%, p = 0.001).

Conclusions

Delirium in a select group of patients with pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related illness was associated with systemic inflammation, severe neurologic injury, and worse clinical outcomes in a multicenter cohort. These findings underscore the importance of routine delirium screening and intervention in children hospitalized with SARS-CoV-2-related illnesses and other inflammatory conditions.