Page 347 - Abstract Book KONIKA 18

Neurology

P-NEU-021
Neurological Manifestation of Children Under 5-year-old with COVID-19:
Case Series from A Rural Hospital

Michelle Angelica Wijaya, Lianda Tamara
Bethesda Serukam Hospital, West Borneo, Indonesia

Abstract
Background Coronavirus disease 2019 (COVID-19) is still high in Indonesia, both in urban and rural
areas. The neurological manifestation was not a common symptom in pediatric COVID-19 cases, and
there is limited pediatric COVID-19 data in Indonesia. Objective To report pediatric COVID-19 case series
with neurological manifestation in children under five years old from a rural hospital in West Borneo.
Cases We encountered 5 COVID-19 cases with neurological manifestations. This observational case series
was taken from patients with PCR result confirmation from August 2020 to July 2021. They all presented
with first onset febrile generalized-type seizure; two had altered consciousness, one with acute lymphoblastic
leukemia as comorbid. One patient had hyponatremia. Protein in CSF analysis was found in 3 out of 4
patients. All patient chest x-ray showed pneumonia. Antigen examination was carried out in 3 patients
according to the onset of symptoms, and only one patient had a positive result. The average length of stay
of our patients was six days. Three patients got discharged before the result of PCR tests came out due to
limited resources. CT scan examination could not be performed because of limited resources. Remdesivir,
high-dose ceftriaxone, dexamethasone, and supportive therapy were given. Three patients had normal
neurological outcomes upon discharge, and the other two eventually developed MIS-C and septic shock,
which led to death. Conclusion This case report highlights critical neurological manifestations of COVID-19
in children that can increase the alertness of pediatricians in diagnosing and treating pediatric COVID-19
patients with neurologic manifestations.
Keywords: COVID-19; neurological manifestation; under-five pediatric COVID-19; seizure

P-NEU-022
Clinical Characteristics and Mortality Predictors of Pediatric Hydrocephalus
Underwent Cerebrospinal Fluid Shunt Therapy at RSUD Dr. Soetomo Surabaya

Nabila Fitri Ariyati, Amrina Rosyada, Prastiya Indra Gunawan
Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo Hospital,
Surabaya, East Java, Indonesia
Abstract
Background Hydrocephalus is one of central nervous system disorders in children. Cerebrospinal fluid
(CSF) shunting remains the treatment of choice for many cases. Despite improvement in shunt technology,
there continues to be a significant mortality rate related CSF shunt. Objective To determine the mortality
predictor related to CSF shunting in pediatric hydrocephalus. Methods An analytic observational study
using secondary data involving 52 pediatric patients who suffered hydrocephalus and underwent CSF
shunting at RSUD dr. Soetomo from January 2014 to September 2016. Analysis was using chi-square and
binary logistic regression. Results There were 52 subjects who met the inclusion criteria. The mortality
of hydrocephalus pediatric underwent CSF shunt was 13,46%. The result of bivariate analysis showed a
significant result of gender with OR value 0.25 (95%CI 0.28 to 2.25; P=0.162), meningoencephalitis with
OR value 0.21 (95%CI 0.037 to 1.15; P=0.083), encephalitis with OR value 0.057 (95%CI 0.004 to 0.744;
P=0.026), and sepsis with OR value 0.057 (95%CI 0.004 to 0.744; P=0;026). The result of multivariate
analysis showed both sepsis and encephalitis had OR values 0.035 (95%CI 0.002 to 0,504) all have P<0,05.
Conclusion Sepsis and encephalitis are mortality predictors of hydrocephalus pediatric underwent CSF shunt.
Keywords: hydrocephalus; pediatric; predictor; mortality; shunt.

KONIKA XVIII Abstract Book 299