Advertisement

Epidemiological characteristics of hospitalized children with viral central nervous system infections in China, 2016–2020

  • Author Footnotes
    # These authors contributed equally.
    Qi Li
    Footnotes
    # These authors contributed equally.
    Affiliations
    Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China

    Research Unit of Critical Infection in Children, 2019RU016, Chinese Academy of Medical Sciences, Beijing, China
    Search for articles by this author
  • Author Footnotes
    # These authors contributed equally.
    Ran Wang
    Footnotes
    # These authors contributed equally.
    Affiliations
    Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China

    Research Unit of Critical Infection in Children, 2019RU016, Chinese Academy of Medical Sciences, Beijing, China
    Search for articles by this author
  • Hui Xu
    Affiliations
    Big Data Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
    Search for articles by this author
  • Linlin Zhang
    Affiliations
    Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China

    Research Unit of Critical Infection in Children, 2019RU016, Chinese Academy of Medical Sciences, Beijing, China
    Search for articles by this author
  • Yiliang Fu
    Affiliations
    Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China

    Research Unit of Critical Infection in Children, 2019RU016, Chinese Academy of Medical Sciences, Beijing, China
    Search for articles by this author
  • Jiao Tian
    Affiliations
    Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China

    Research Unit of Critical Infection in Children, 2019RU016, Chinese Academy of Medical Sciences, Beijing, China
    Search for articles by this author
  • Mengjia Liu
    Affiliations
    Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China

    Research Unit of Critical Infection in Children, 2019RU016, Chinese Academy of Medical Sciences, Beijing, China
    Search for articles by this author
  • Guoshuang Feng
    Affiliations
    Big Data Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
    Search for articles by this author
  • Yueping Zeng
    Affiliations
    Medical Record Management Office, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
    Search for articles by this author
  • Xiangpeng Chen
    Correspondence
    Corresponding authors: Xiangpeng Chen
    Affiliations
    Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China

    Research Unit of Critical Infection in Children, 2019RU016, Chinese Academy of Medical Sciences, Beijing, China
    Search for articles by this author
  • Zhengde Xie
    Correspondence
    Corresponding authors: Zhengde Xie
    Affiliations
    Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China

    Research Unit of Critical Infection in Children, 2019RU016, Chinese Academy of Medical Sciences, Beijing, China
    Search for articles by this author
  • Author Footnotes
    # These authors contributed equally.

      ABSTRACT

      Background

      Viral central nervous system (CNS) infections seriously threaten the life and health of children, with a high mortality and severe sequelae in China and globally. Surveillance of viral CNS infections in children is important, especially in hospitalized children, to facilitate disease evaluation.

      Methods

      In this study, we collected the data on the discharged Face Sheet of Medical Records from database from 2016 to 2020 and analyzed the epidemiological characteristics, length of stay, and expense of hospitalized children (≤18 years old) with viral CNS infections in China. We classified the discharge diagnosis of viral CNS infection as viral encephalitis (VE), viral meningitis (VM), viral meningoencephalitis (VME), viral encephalomyelitis (VEM), and viral meningomyelitis (VMM).

      Results

      A total of 42,641 cases of viral CNS infections were included in the database, consisting of 39,279 cases with VE (92.47%), 2,011 cases with VM (4.73%), 1,189 cases with VME (2.80%), 118 cases with VEM (0.28%), and 44 cases with VMM (0.10%). The number of hospitalized patients with viral CNS infections accounted for 0.74% (42,641/5,790,910) of all hospitalized cases. The onset of viral CNS infections presented seasonal characteristic, with a peak in June–July and a peak in December–January. Seizures is the most frequent complication of this disorder. Median length of stay and inpatient expenditures for patients with viral CNS infections were 9 d and 1,144.36 USD. Causative viruses were identified in 4.33% (1,848/42,641) of patients.

      Conclusions

      This study will help understand the clinical epidemiology of hospitalized children with viral CNS infections in China.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Pediatric Neurology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • McGill F.
        • Griffiths M.J.
        • Solomon T.
        Viral meningitis: current issues in diagnosis and treatment.
        Curr Opin Infect Dis. 2017; 30: 248-256https://doi.org/10.1097/QCO.0000000000000355
        • Kakooza-Mwesige A.
        • Tshala-Katumbay D.
        • Juliano S.L.
        Viral infections of the central nervous system in Africa.
        Brain Res Bull. 2019; 145: 2-17https://doi.org/10.1016/j.brainresbull.2018.12.019
        • Brouwer M.C.
        • van de Beek D.
        Viral meningitis in the UK: time to speed up.
        The Lancet Infectious Diseases. 2018; 18: 930-931https://doi.org/10.1016/s1473-3099(18)30287-1
        • Dubey D.
        • Pittock S.J.
        • Kelly C.R.
        • et al.
        Autoimmune encephalitis epidemiology and a comparison to infectious encephalitis.
        Ann Neurol. 2018; 83: 166-177https://doi.org/10.1002/ana.25131
        • Venkatesan A.
        • Murphy O.C.
        Viral Encephalitis.
        Neurol Clin. 2018; 36: 705-724https://doi.org/10.1016/j.ncl.2018.07.001
        • Wang L.P.
        • Yuan Y.
        • Liu Y.L.
        • et al.
        Etiological and epidemiological features of acute meningitis or encephalitis in China: a nationwide active surveillance study.
        Lancet Reg Health West Pac. 2022; 20100361https://doi.org/10.1016/j.lanwpc.2021.100361
        • Tyler K.L.
        Acute Viral Encephalitis.
        N Engl J Med. 2018; 379: 557-566https://doi.org/10.1056/NEJMra1708714
        • Messacar K.
        • Fischer M.
        • Dominguez S.R.
        • et al.
        Encephalitis in US Children.
        Infect Dis Clin North Am. 2018; 32: 145-162https://doi.org/10.1016/j.idc.2017.10.007
        • Lyons J.L.
        Viral Meningitis and Encephalitis.
        Continuum (Minneap Minn). 2018; 24 (Neuroinfectious Disease): 1284-1297https://doi.org/10.1212/CON.0000000000000650
        • Mathew S.
        • Al Khatib H.A.
        • Al Ansari K.
        • et al.
        Epidemiology Profile of Viral Meningitis Infections Among Patients in Qatar (2015-2018).
        Front Med (Lausanne). 2021; 8663694https://doi.org/10.3389/fmed.2021.663694
        • de Oliveira D.B.
        • Candiani T.M.
        • Franco-Luiz A.P.M.
        • et al.
        Etiological agents of viral meningitis in children from a dengue-endemic area, Southeast region of Brazil.
        J Neurol Sci. 2017; 375: 390-394https://doi.org/10.1016/j.jns.2017.02.025
        • Geteneh A.
        • Kassa T.
        • Alemu D.
        • et al.
        Viral Etiologies of Meningitis in Patients with Presumed Pyogenic Meningitis at University Hospitals in Ethiopia.
        Infect Drug Resist. 2021; 14: 1083-1088https://doi.org/10.2147/IDR.S304521
        • Torun S.H.
        • Kaba O.
        • Yakut N.
        • et al.
        Multicenter prospective surveillance study of viral agents causing meningoencephalitis.
        Sci Rep. 2021; 11: 7216https://doi.org/10.1038/s41598-021-86687-0
        • Asundi A.
        • Cervantes-Arslanian A.M.
        • Lin N.H.
        • et al.
        Infectious Myelitis. Semin Neurol. 2019; 39: 472-481https://doi.org/10.1055/s-0039-1688923
        • Murphy O.C.
        • Messacar K.
        • Benson L.
        • et al.
        Acute flaccid myelitis: cause, diagnosis, and management.
        The Lancet. 2021; 397: 334-346https://doi.org/10.1016/s0140-6736(20)32723-9
        • Ai J.
        • Xie Z.
        • Liu G.
        • et al.
        Etiology and prognosis of acute viral encephalitis and meningitis in Chinese children: a multicentre prospective study.
        BMC Infect Dis. 2017; 17: 494https://doi.org/10.1186/s12879-017-2572-9
        • Shen H.
        • Zhu C.
        • Liu X.
        • et al.
        The etiology of acute meningitis and encephalitis syndromes in a sentinel pediatric hospital, Shenzhen, China.
        BMC Infect Dis. 2019; 19: 560https://doi.org/10.1186/s12879-019-4162-5
        • Wang X.
        • Zeng Y.
        • Tian J.
        • et al.
        A brief introduction to the FUTang Updating medical REcords (FUTURE) database.
        Pediatr Investig. 2021; 5: 247-248https://doi.org/10.1002/ped4.12297
        • Wang R.
        • Wang X.
        • Zhang L.
        • et al.
        The epidemiology and disease burden of children hospitalized for viral infections within the family Flaviviridae in China: A national cross-sectional study.
        PLoS Negl Trop Dis. 2022; 16e0010562https://doi.org/10.1371/journal.pntd.0010562
      1. Bai S. Diagnostic criteria for neurological diseases: Scientific and technical documentation press 2009.

        • Kadambari S.
        • Okike I.
        • Ribeiro S.
        • et al.
        Seven-fold increase in viral meningo-encephalitis reports in England and Wales during 2004-2013.
        J Infect. 2014; 69: 326-332https://doi.org/10.1016/j.jinf.2014.05.012
        • Chen Y.
        • Klein S.L.
        • Garibaldi B.T.
        • et al.
        Aging in COVID-19: Vulnerability, immunity and intervention.
        Ageing Res Rev. 2021; 65101205https://doi.org/10.1016/j.arr.2020.101205
        • Toczylowski K.
        • Wieczorek M.
        • Bojkiewicz E.
        • et al.
        Pediatric Enteroviral Central Nervous System Infections in Bialystok, Poland: Epidemiology, Viral Types, and Drivers of Seasonal Variation.
        Viruses. 2020; 12https://doi.org/10.3390/v12080893
        • Moltoni G.
        • D'Arco F.
        • Pasquini L.
        • et al.
        Non-congenital viral infections of the central nervous system: from the immunocompetent to the immunocompromised child.
        Pediatr Radiol. 2020; 50: 1757-1767https://doi.org/10.1007/s00247-020-04746-6
        • Ben Abid F.
        • Abukhattab M.
        • Ghazouani H.
        • et al.
        Epidemiology and clinical outcomes of viral central nervous system infections.
        Int J Infect Dis. 2018; 73: 85-90https://doi.org/10.1016/j.ijid.2018.06.008
        • Su S.B.
        • Chang H.L.
        • Chen A.K.
        Current Status of Mumps Virus Infection: Epidemiology, Pathogenesis, and Vaccine.
        Int J Environ Res Public Health. 2020; 17https://doi.org/10.3390/ijerph17051686
        • Lynch J.P.
        • Kajon A.E.
        Adenovirus: Epidemiology, Global Spread of Novel Serotypes, and Advances in Treatment and Prevention.
        Seminars in respiratory and critical care medicine. 2016; 37: 586-602https://doi.org/10.1055/s-0036-1584923
        • Shane A.L.
        • Sánchez P.J.
        • Stoll B.J.
        Neonatal sepsis.
        The Lancet. 2017; 390: 1770-1780https://doi.org/10.1016/s0140-6736(17)31002-4
        • Schwartz K.L.
        • Richardson S.E.
        • MacGregor D.
        • et al.
        Adenovirus-Associated Central Nervous System Disease in Children.
        J Pediatr. 2019; 205: 130-137https://doi.org/10.1016/j.jpeds.2018.09.036