Electroencephalographic findings among inpatients with COVID-19 in a tertiary hospital from a middle-income country

Corazza, Luíza Alves; Tatsch, João Fellipe Santos; Barros, Maraysa Pereira; Queiroz, Apolônio Peixoto de; Batista, Luana Lôbo Ribeiro; Aidar, Mariana Barbosa; Baldocchi, Meire Argentoni; Rocha, Maria Sheila Guimarães; Brucki, Sônia Maria Dozzi

doi:10.1590/0004-282x-anp-2020-0555

Cited by 4 publications

(2 citation statements)

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“…Occurrence of seizures or epileptiform abnormalities was rather low in our series ( n = 6, 12%), in line with other studies [ 2 , 7 , 13 – 15 , 19 ]. However, it must be acknowledged that short recording duration could have underestimated the rate of seizures and epileptiform activity [ 21 ], even if this limitation is partially compensated by higher recording repetition compared to the other studies.…”

Section: Discussionsupporting

confidence: 93%

“…Diffuse attenuation has also been reported in other case series, but almost always in small percentages [ 2 , 7 , 18 ] or presumably none [ 13 , 14 ]. Higher prevalence of attenuated patterns was reported in two more recent studies, reaching 21–25% of cases [ 16 , 19 ]. The association between generalized attenuation and higher mortality was postulated but not confirmed [ 16 ].…”

Section: Discussionmentioning

confidence: 81%

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The value of EEG attenuation in the prediction of outcome in COVID-19 patients

et al. 2022

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Introduction During the COVID-19 pandemic, electroencephalography (EEG) proved to be a useful tool to demonstrate brain involvement. Many studies reported non-reactive generalized slowing as the most frequent pattern and epileptiform activity in a minority of patients. Objective To investigate the prevalence of diffuse unreactive background attenuation or suppression and its correlation with outcome in a cohort of COVID-19 patients. Methods The EEGs recorded during the first year of the COVID-19 pandemic were retrospectively evaluated to identify the main pattern and focus on the occurrence of a low-voltage background, either attenuated (10–20 μV) or suppressed (< 10 μV). We sought a correlation between in-hospital mortality and low-voltage EEG. In a subsample of patients, biomarkers of inflammation, hypoxemia and organ failure were collected. Brain imaging was also evaluated. Results Among 98 EEG performed in 50 consecutive patients, diffuse unreactive slowing was the most prevalent pattern (54%), followed by unreactive attenuation or suppression pattern (26%), being the latter significantly correlated with an unfavourable outcome (p = 0.0004). Survivors showed significantly lower interleukine-6 values compared to non-survivors. Patients with attenuated EEG and non-survivors also showed lower PaO2/FiO2 values. Neuroradiological findings were very heterogeneous with a prevalence of lesions suggestive of a microangiopathic substrate. Conclusions EEG attenuation or suppression may be more frequent than previously reported and significantly associated with a poor outcome. SARS-CoV-2 infection may result in encephalopathy and reduced EEG voltage through mechanisms that are still unknown but deserve attention given its negative impact on prognosis.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 81%

The value of EEG attenuation in the prediction of outcome in COVID-19 patients

et al. 2022

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Electroencephalographic features with COVID-19

Sáez-Landete,

Gómez-Domínguez,

Estrella-León

et al. 2024

Linking Neuroscience and Behavior in COVID-19

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Non-Invasive Multimodal Neuromonitoring in Non-Critically Ill Hospitalized Adult Patients With COVID-19: A Systematic Review and Meta-Analysis

et al. 2022

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IntroductionNeurological complications are frequent in patients with coronavirus disease-2019 (COVID-19). The use of non-invasive neuromonitoring in subjects without primary brain injury but with potential neurological derangement is gaining attention outside the intensive care unit (ICU). This systematic review and meta-analysis investigates the use of non-invasive multimodal neuromonitoring of the brain in non-critically ill patients with COVID-19 outside the ICU and quantifies the prevalence of abnormal neuromonitoring findings in this population.MethodsA structured literature search was performed in MEDLINE/PubMed, Scopus, Cochrane, and EMBASE to investigate the use of non-invasive neuromonitoring tools, including transcranial doppler (TCD); optic nerve sheath diameter (ONSD); near-infrared spectroscopy (NIRS); pupillometry; and electroencephalography (EEG) inpatients with COVID-19 outside the ICU. The proportion of non-ICU patients with CVOID-19 and a particular neurological feature at neuromonitoring at the study time was defined as prevalence.ResultsA total of 6,593 records were identified through literature searching. Twenty-one studies were finally selected, comprising 368 non-ICU patients, of whom 97 were considered for the prevalence of meta-analysis. The pooled prevalence of electroencephalographic seizures, periodic and rhythmic patterns, slow background abnormalities, and abnormal background on EEG was.17 (95% CI 0.04–0.29), 0.42 (95% CI 0.01–0.82), 0.92 (95% CI 0.83–1.01), and.95 (95% CI 0.088–1.09), respectively. No studies investigating NIRS and ONSD outside the ICU were found. The pooled prevalence for abnormal neuromonitoring findings detected using the TCD and pupillometry were incomputable due to insufficient data.ConclusionsNeuromonitoring tools are non-invasive, less expensive, safe, and bedside available tools with a great potential for both diagnosis and monitoring of patients with COVID-19 at risk of brain derangements. However, extensive literature searching reveals that they are rarely used outside critical care settings.Systematic Review Registration:www.crd.york.ac.uk/prospero/display_record.php?RecordID=265617, identifier: CRD42021265617.

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Electroencephalographic findings among inpatients with COVID-19 in a tertiary hospital from a middle-income country

Cited by 4 publications

References 40 publications

The value of EEG attenuation in the prediction of outcome in COVID-19 patients

The value of EEG attenuation in the prediction of outcome in COVID-19 patients

Electroencephalographic features with COVID-19

Non-Invasive Multimodal Neuromonitoring in Non-Critically Ill Hospitalized Adult Patients With COVID-19: A Systematic Review and Meta-Analysis

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