TY - JOUR
T1 - Delirium in Children Hospitalized with Acute COVID-19 or MIS-C
T2 - Secondary Analysis of the 2020–2021 Global Consortium Study of Neurologic Dysfunction in COVID-19
AU - The Global Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID) Investigators
AU - Marupudi, Neelima K.
AU - Serna, Diana Paola Escobar
AU - Dervan, Leslie
AU - Janas, Anna
AU - Geneslaw, Andrew S.
AU - Fink, Ericka L.
AU - Giraldo, Juan David Roa
AU - Akande, Emily Davies Manzi
AU - Miles, Darryl
AU - Serratore, Alyssa
AU - Cronin, Michael
AU - Balaban, Burak
AU - Dufour, Marianne
AU - Riviello, James J.
AU - Czech, Theresa
AU - Smith, Craig
AU - Simmons, Jennifer
AU - Schober, Michelle
AU - Yock-Corrales, Adriana
AU - Umaña-Calderón, Andres
AU - Sevilla-Acosta, Fabricio
AU - Bogantes-Ledezma, Sixto
AU - Price, Dana
AU - Nelson, Aaron
AU - Bhagat, Dhristie
AU - Doerfler, Matthew
AU - Muller, William
AU - Tasayco-Munoz, Jaime
AU - Vargas, Wendy
AU - Lin, Jieru
AU - Silver, Wendy
AU - Pryce, Patrice
AU - Sewell, Taylor
AU - Rodriguez, Isadora
AU - Wainwright, Mark
AU - Barón, Facundo Jorro
AU - Santos, Laura
AU - Drury, Kurt
AU - Walker, Tracie
AU - Ulate-Campos, Adriana
AU - Topjian, Alexis A.
AU - Mcguire, Jennifer
AU - Pal, Ria
AU - Guilliams, Kristin
AU - Snooks, Kellie
AU - Farias-Moeller, Raquel
AU - Butt, Warwick
AU - Gutierrez-Mata, Alfonso
AU - Waak, Michaela
AU - Lovett, Marlina
N1 - Publisher Copyright:
© Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2026.
PY - 2026
Y1 - 2026
N2 - 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.
AB - 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.
KW - Biomarkers
KW - COVID-19
KW - Delirium
KW - Hospitalized child
KW - Inflammation
KW - Neuroimaging
UR - https://www.scopus.com/pages/publications/105035630110
U2 - 10.1007/s12028-026-02503-5
DO - 10.1007/s12028-026-02503-5
M3 - Article
C2 - 41942816
AN - SCOPUS:105035630110
SN - 1541-6933
JO - Neurocritical Care
JF - Neurocritical Care
ER -