Electroencephalographic findings in COVID-19 patients: A systematic review

Roberto, Katrina T.; Espiritu, Adrian I.; Fernandez, Marc Laurence L.; Gutierrez, Josephine C.

doi:10.1016/j.seizure.2020.09.007

Cited by 38 publications

(55 citation statements)

References 51 publications

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“…We report on a cohort of 78 patients with COVID-19 who underwent EEG for a wide range of CNS manifestations. Recent case reports, small series, and meta-analyses assessing the value of EEG for patients with COVID-19 5 , 6 , 7 , 8 , 9 , 14 , 15 , 16 , 17 showed (1) nonspecific patterns, reflecting the diversity of SARS-CoV-2 infection complications, 1 , 7 , 9 , 14 , 15 , 16 , 17 or (2) a striking periodic EEG pattern, 5 , 6 , 8 , 17 suggestive of COVID-19–specific brain complications. Nevertheless, a systematic correlation of EEG findings with biological findings and brain MRI findings was lacking, precluding a better understanding of pattern origins.…”

Section: Discussionmentioning

confidence: 99%

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Association of Clinical, Biological, and Brain Magnetic Resonance Imaging Findings With Electroencephalographic Findings for Patients With COVID-19

et al. 2021

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Key Points Question Can electroencephalography (EEG), combined with clinical, biological, and magnetic resonance imaging (MRI) analyses, help to better characterize patients with neurologic coronavirus disease 2019 (COVID-19) and diagnose specific COVID-19–related encephalopathy? Findings Neurologic manifestations, biological findings, EEG findings, and brain MRI images were analyzed in a cohort study of 78 adult patients with COVID-19. Nine patients had no identified cause of brain injury, as revealed by biological and MRI findings; their injury was defined as COVID-19–related encephalopathy. Meaning This study suggests that, although neurologic manifestations, EEG findings, and MRI findings may appear heterogeneous and nonspecific, multimodal monitoring may better identify patients with COVID-19–related encephalopathy and guide treatment strategy.

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Section: Discussionmentioning

confidence: 99%

“… 6 To our knowledge, few studies have evaluated EEG findings together with clinical, biological, and MRI findings in patients with COVID-19, and these studies did not show evidence of specific patterns. 7 , 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

Association of Clinical, Biological, and Brain Magnetic Resonance Imaging Findings With Electroencephalographic Findings for Patients With COVID-19

et al. 2021

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“…Two systematic review studies with similar clinical questions have been previously reported [32] , [33] . Our meta-analysis provided additional value to those studies.…”

Section: Discussionmentioning

confidence: 84%

Meta-analysis of EEG findings in patients with COVID-19

Kubota

Gajera

Kuroda

2021

Epilepsy & Behavior

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“…A prior systematic review of 177 patients reported that EEG findings are non-specific in COVID-19, with a majority (63.8%) of the cases having generalized slowing, 3.5% with normal EEG, and 19.2% with epileptiform activity [3] . Status epilepticus was reported in 4.5% of the patients [3] , comparable to 5% of patients in our study (4% nonconvulsive, 1% convulsive). Compared to a cohort study from New York City, our cohort exhibited similar rates of clinical seizures at 10% (12/110) of the patients which is comparable to that study of clinical seizures in 7% of the patients [8] .…”

Section: Discussionmentioning

confidence: 99%

“…Seizures and status epilepticus (SE) have been reported with COVID-19, with new onset or exacerbation of existing epilepsy and the prevalence of seizures in patients with COVID-19 is still unknown. Multiple studies have recognized electroencephalography (EEG) changes in COVID-19, utilizing short- and long-term EEG recording, though no clear EEG pattern is reliably seen in this patient population [3] . Furthermore, the effects of seizures, clinical or subclinical (electrographic), on the functional outcome in critically ill patients with COVID-19 remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of seizures, status epilepticus, and EEG findings in critically ill patient with COVID-19

Danoun

Zillgitt

Hill

et al. 2021

Epilepsy & Behavior

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Objective Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has a myriad of neurological manifestations and its effects on the nervous system are increasingly recognized. Seizures and status epilepticus (SE) are reported in the novel coronavirus disease (COVID-19), both new onset and worsening of existing epilepsy, however the exact prevalence is still unknown. The primary aim of this study was to correlate the presence of seizures, status epilepticus, and specific critical care EEG patterns with patient functional outcomes in those with COVID-19. Methods This is a retrospective, multicenter cohort of COVID-19 positive patients in Southeast Michigan who underwent electroencephalography (EEG) from March 12 th through May 15 th , 2020. All patients had confirmed nasopharyngeal PCR for COVID-19. EEG patterns were characterized per 2012 ACNS critical care EEG terminology. Clinical and demographic variables were collected by medical chart review. Outcomes were divided into recovered, recovered with disability, or deceased. Results Out of the total of 4100 patients hospitalized with COVID-19, 110 patients (2.68%) had EEG during their hospitalization; 64% were male, 67% were African American with mean age of 63 years (range 20-87). The majority (70%) had severe COVID-19 were intubated or had multiorgan failure. The median length of hospitalization was 26.5 days (IQR=15 to 44 days). During hospitalization, of the patients who had EEG, 21.8% had new onset seizure including 7% with status epilepticus, majority (87.5%) with no prior epilepsy. Forty-nine (45%) patients died in the hospital, 46 (42%) recovered but maintained a disability and 15 (14%) recovered without a disability. The EEG findings associated with outcomes were background slowing/attenuation (recovered 60% vs recovered/disabled 96% vs died 96%, p<0.001) and normal (recovered 27% vs recovered/disabled 0% vs died 1%, p<0.001). However, these findings were no longer significant after adjusting for severity of COVID-19. Conclusion In this large multi-center study from Southeast Michigan, one of the early COVID-19 epicenters in the US, none of the EEG findings were significantly correlated with outcomes in critically ill COVID-19 patients. Although seizures and status epilepticus could be encountered in COVID-19, the occurrence did not correlate with the patients’ functional outcome.

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Electroencephalographic findings in COVID-19 patients: A systematic review

Abstract: Graphical abstract

Cited by 38 publications

References 51 publications

Association of Clinical, Biological, and Brain Magnetic Resonance Imaging Findings With Electroencephalographic Findings for Patients With COVID-19

Association of Clinical, Biological, and Brain Magnetic Resonance Imaging Findings With Electroencephalographic Findings for Patients With COVID-19

Meta-analysis of EEG findings in patients with COVID-19

Outcomes of seizures, status epilepticus, and EEG findings in critically ill patient with COVID-19

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