Neurodevelopment medium-term outcome after parechovirus infection

Early Hum Dev. 2019 May;132:1-5. doi: 10.1016/j.earlhumdev.2019.03.005. Epub 2019 Mar 22.


Aim: Human parechoviruses (HPeV) are responsible for fever without a source (FWS), sepsis-like illness and encephalitis in neonates and children under 3 months of age. Short-term outcome is generally good, but there is great concern about medium and long- term outcome of infants after HPeV infection. The aim of this study is to assess the medium-term outcome in infants following HPeV infection without encephalitis.

Methods: Patients who suffered HPeV infection involving cerebrospinal fluid were evaluated twice using Ages and Stages Questionnaire-3 (ASQ-3). The first evaluation was conducted at least one year after the infection and the second one year later.

Results: Sixteen patients were evaluated in the first assessment, and three of them presented mild alterations in motor function domains. Moreover, hypotonia was observed in the neurologic exam in one case, and hemiparesis in another case. In the second assessment fifteen patients were included, and only the patient with hemiparesis continued presenting gross motor disfunction, with complete recovery of the remaining patients.

Interpretation: We have observed a good medium-term prognosis in infants after HPeV infections, with improvement of mild motor alterations after at-home intervention. Infants who suffer HPeV infection without encephalitis seem to have a better prognosis than those with encephalitis.

Keywords: ASQ-3; Fever without source; Neurodevelopment; Outcome; Parechovirus; Sepsis-like illness.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child, Preschool
  • Developmental Disabilities / epidemiology*
  • Female
  • Humans
  • Infant
  • Male
  • Muscle Hypotonia / epidemiology*
  • Paresis / epidemiology*
  • Picornaviridae Infections / complications*
  • Picornaviridae Infections / diagnosis
  • Picornaviridae Infections / epidemiology
  • Prognosis