Analysis of clinical characteristics of febrile seizures in children with COVID-19: a retrospective study

Background Transmission of COVID-19 is now normalized. COVID-19 can invade the central nervous system, cause abnormalities in the nervous system, and is associated with an increased incidence of febrile seizures in children. This study is to compare the differences in clinical features, hematological features, and cerebrospinal fluid characteristics between COVID-19 and non-COVID-19 children with febrile seizures and to explore the clinical characteristics of febrile seizures caused by COVID-19. Methods This was a retrospective case-control study. The cases included children with COVID-19 and non-COVID-19 febrile seizures admitted to Xiamen Children's Hospital from December 2022 to December 2023. The age, gender, length of hospital stay, peak body temperature, presence or absence of other viral infections, hematological characteristics, and cerebrospinal fluid characteristics were compared between children with COVID-19 febrile seizures and non-COVID-19 febrile seizures. Results A total of 50 COVID-19 children with febrile seizures and 192 non-COVID-19 children with febrile seizures were enrolled in this study. Multivariate analysis showed that age (OR=0.715, P =0.031), blood urea nitrogen (OR=0.454, P =0.029), platelet count (OR=0.987, P =0.009), and magnesium ion concentration (OR=0.109, P <0.001) were independent protective factors for COVID-19 febrile seizures. Albumin (OR=1.840, P <0.001) was an independent risk factor. The concentration of potassium ions in cerebrospinal fluid(OR=4.383, P =0.022)was an independent protective factor, while the concentration of sodium ions (OR=4.383, P =0.022) was an independent risk factor. Conclusion There were differences in age, blood urea nitrogen, platelet count, magnesium ion concentration, albumin, potassium ion concentration in cerebrospinal fluid, and sodium ion concentration in the cerebrospinal fluid between children with COVID-19 febrile seizures and non-COVID-19 febrile seizures. This study may provide valuable insights into the potential mechanisms of COVID-19 damage to the nervous system in children, and the long-term neurological prognosis of these children requires long-term follow-up.