Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link

Volume 32, Number 2—February 2026

Synopsis

Life-Threatening SARS-CoV-2–Associated Encephalopathy and Multiorgan Failure in Children, Asia and Oceania, 2022–2024

Mariko Kasai1, Hiroshi SakumaComments to Author , Motomasa Suzuki1, Masahiro Nishiyama1, Nanako Kawata1, Jainn-Jim Lin1, Kuang-Lin Lin, Velda Han, Shekeeb S. Mohammad, Russell C. Dale, Terrence Thomas, Kazuhiro Muramatsu, Osamu Mitani, Yoshiyuki Kobayashi, Kouhei Ishida, Yuichi Abe, Ichiro Kuki, and Jun-ichi Takanashi
Author affiliation: Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan (M. Kasai, H. Sakuma); Aichi Children's Health and Medical Center, Aichi, Japan (M. Suzuki); Hyogo Prefectural Kobe Children’s Hospital, Kobe, Japan (M. Nishiyama); Tokyo Metropolitan Children’s Medical Center, Tokyo (N. Kawata); Chang Gung Children’s Hospital and Chang Gung Memorial Hospital, School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan (J.-J. Lin, K.-L. Lin); Khoo Teck Puat-National University Children’s Medical Institute, Singapore (V. Han); Yong Loo Lin School of Medicine, National University of Singapore, Singapore (V. Han); Kids Neuroscience Centre, The Children’s Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia (V. Han, S.S. Mohammad, R.C. Dale); KK Women’s and Children’s Hospital, Singapore (T. Thomas); Jichi Medical University, Tochigi, Japan (K. Muramatsu); Fukuyama City Hospital, Hiroshima, Japan (O. Mitani); Hiroshima University Hospital, Hiroshima (Y. Kobayashi); Sapporo Medical University School of Medicine, Sapporo, Japan (K. Ishida); National Center for Child Health and Development, Tokyo (Y. Abe); Osaka City General Hospital, Osaka, Japan (I. Kuki); Tokyo Women’s Medical University Yachiyo Medical Center, Chiba, Japan (J. Takanashi)

Main Article

Table 2

Frequency of shock and signs of multiorgan failure in patients with SARS-CoV-2 ASEM/AFCE in study of life-threatening SARS-CoV-2–associated encephalopathy and multiorgan failure in children, Asia and Oceania, 2022–2024*

Symptoms No. (%) cases
Shock 24 (96)
DIC 22 (88)
Elevated AST or ALT† 25 (100)
Elevated BUN or creatinine 25 (100)
Thrombocytopenia‡ 21 (84)
Reduced hemoglobin§ 15 (60)
Metabolic acidosis 24 (96)

*ALT, alanine aminotransferase; AFCE, acute fulminant cerebral edema; ASEM, acute shock with encephalopathy and multiorgan failure; AST, aspartate aminotransferase; BUN, blood urea nitrogen; DIC, disseminated intravascular coagulation. †A total of 22 patients had AST or ALT elevations with a >4-digit range. ‡Platelet count <150,000/µL. §Hemoglobin level decreased by >3 g/dL from admission.

Main Article

1These authors contributed equally to this article.

Page created: January 22, 2026
Page updated: February 19, 2026
Page reviewed: February 19, 2026
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external