Electroencephalogram (EEG) in COVID-19: A systematic retrospective study

Abstract

Objectives.-Although rare, neurological manifestations in SARS-CoV-2 infection are increasingly being reported. We conducted a retrospective systematic study to describe the electroencephalography (EEG) characteristics in this disease, looking for specific patterns. Methods.-EEGs performed in patients with positive PCR for SARS-CoV-2 between 25/03/2020 and 06/05/2020 in the University Hospital of Bicêtre were independently reviewed by two experienced neurologists. We used the American Clinical Neurophysiology Society's terminology for the description of abnormal patterns. EEGs were classified into five categories, from normal to critically altered. Interobserver reliability was calculated using Cohen's kappa coefficient. Medical records were reviewed to extract demographics, clinical, imaging and biological data. Results.-Forty EEGs were reviewed in 36 COVID-19 patients, 18 in intensive care units (ICU) and 22 in medicine units. The main indications were confusion or fluctuating alertness for 23 (57.5%) and delayed awakening after stopping sedation in ICU in six (15%). EEGs were normal to mildly altered in 23 (57.5%) contrary to the 42.5% where EEG alterations were moderate in four (10%), severe in eight (20%) and critical in five (12.5%). Generalized periodic discharges (GPDs), multifocal periodic discharges (MPDs) or rhythmic delta activity (RDA) were found in 13 recordings (32.5%). EEG alterations were not stereotyped or specific. They could be related to an underlying morbid status, except for three ICU patients with unexplained encephalopathic features. Conclusion.-In this first systematic analysis of COVID-19 patients who underwent EEG, over half of them presented a normal recording pattern. EEG alterations were not different from those encountered in other pathological conditions.

Brain abnormalities in COVID-19 acute/subacute phase: A rapid systematic review

“…Additional three article were excluded as the relationship between brain abnormalities and COVID-19 infection was noted by the authors as improbable. In detail, the authors attributed reported brain abnormalities rather to other/pre-existing medical conditions, previous pathological situations or interpreted them as potentially coincidental with COVID-19 (Morrasi et al, 2020;Degeneffe et al, 2020;Petrescu et al, 2020). Therefore, we entered a total of 26 articles (including 21 case reports, and 5 cohort studies) into the final synthesis.…”

Neurological Complications of COVID-19 and Possible Neuroinvasion Pathways: A Systematic Review

“…In total, 6890 patients were included in the studies. Among the 68 studies on the CNS effects, 46 were case reports [16,17,, followed by 10 retrospective studies [64][65][66][67][68][69][70][71][72][73], 4 observational cohort studies [74][75][76][77], 3 prospective studies [78][79][80], 3 case-control studies [81][82][83] and 2 cross-sectional studies [84,85]. Among the 21 studies regarding PNS disorders, there were 19 case reports [86][87][88][89][90][91][92][93][94][95][96][97][98][99][100][101][102][103][104], 1 prospective study [78] and 1 retrospective study [68].…”

“…F, female; OR, odd ratio. * Other Neurological Conditions were the following: brain edema [41]; headache [78]; impaired consciousness [68,78]; dizziness [78]; acute mania [45]; intracranial hypertension [48]; electroencephalography alterations [70]; vasculopathy [72]; and brain and spine demyelination [61].…”

“…An exhaustive systematic retrospective study was conducted by Petrescu and colleagues [70] who shed light on important EEG findings associated with SARS-CoV-2 infection. EEG was performed in 36 patients with an age ranging from 43 to 97 years.…”

COVID-19 EEG Studies: The Other Coronavirus Spikes We Need to Worry About

“…The third study, a single institution retrospective review from France (Petrescu et al 12 ), reports 40 consecutive routine EEGs from 36 patients who tested positive for COVID, after excluding brain death studies and asymptomatic patients, half of the patients from the ICU. Electroencephalograms were normal or nearly normal in a little more than half of the recordings (57.5%).…”