COVID-19 Incidence and Death Rate in Epilepsy: Too Early to Tell?

Abstract

[Box: see text]

Does SARS-CoV-2 Cause Seizures and Epilepsy in COVID-19 via Inflammation or by Direct Infection?

“…There was evidence early on that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can infect brain tissue. 1 Early studies on whether SARS-CoV-2 infection could cause seizures and resultant epilepsy and whether COVID-19 and its sequelae were more prevalent or severe in persons with preexisting epilepsy were difficult to interpret because SARS-CoV-2 antigen tests had not yet been developed or widely deployed. 1 -3 In 2020 and 2021, it was observed that COVID-19 patients hospitalized with severe pulmonary signs sometimes had encephalopathy, but acute seizures and status epilepticus appeared to be relatively uncommon.…”

“…1 Early studies on whether SARS-CoV-2 infection could cause seizures and resultant epilepsy and whether COVID-19 and its sequelae were more prevalent or severe in persons with preexisting epilepsy were difficult to interpret because SARS-CoV-2 antigen tests had not yet been developed or widely deployed. [1][2][3] In 2020 and 2021, it was observed that COVID-19 patients hospitalized with severe pulmonary signs sometimes had encephalopathy, but acute seizures and status epilepticus appeared to be relatively uncommon. [4][5][6] Taquet et al questioned whether patients with COVID-19 were more likely than controls to develop seizures or epilepsy.…”

COVID-19 vaccination status and related process of care outcomes among U.S. adults with active epilepsy—National Health Interview Survey, United States, 2021

“…Although active epilepsy itself has not been associated with worse COVID-19 outcomes to date, several studies have suggested those with various neurologic conditions, disabilities, and mental health conditions in which epilepsy may co-occur (e.g., cerebral palsy, dementia, Down Syndrome) may be at higher risk for such outcomes [1] , [2] , [3] , [4] . Growing research has examined the effects of COVID-19 infection among people with epilepsy, safety and tolerability of the COVID-19 vaccines, and COVID-19 vaccination status among people with epilepsy [5] , [6] , [7] , [8] , [9] , [10] . A review examining COVID-19 vaccination coverage and willingness to be vaccinated against COVID-19 based on international samples of patients with epilepsy (up to April 30, 2022) reported suboptimal levels of COVID-19 vaccination coverage and intent to vaccinate [11] .…”

Comments on: Clinical characteristics of unvaccinated or incompletely vaccinated children with neurological manifestations due to SARS‐CoV‐2 Omicron infection

“…Therefore, failure to exclude patients infected with these viruses might have influenced the findings of the study. 2,3 Fourth, a study conducted in the United States pointed out disparities in the incidence of COVID-19, demonstrating that Hispanics and Blacks have an increased likelihood of getting this disease. 4 The results of this research emphasize the significant role of both race and ethnicity as confounders in studies involving COVID-19 patients.…”