Epilepsy and COVID-19: Associations and important considerations

Kuroda, Naoto

doi:10.1016/j.yebeh.2020.107122

Cited by 101 publications

(133 citation statements)

References 19 publications

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“…[26][27][28] The Centers for Disease Control and Prevention have suggested that some neurologic diseases such as epilepsy might be a risk factor for COVID-19, partly due to the increased rate of comorbidities associated with these patients. 16 Because there is very limited evidence of COVID-19 in patients with epilepsy, we conducted this study to determine the incidence and fatality rate of this disease in patients with active epilepsy, as well as potential risk factors that could be associated with fatality. We also studied active epilepsy as a possible risk factor for fatality in hospitalized patients with COVID-19.…”

Section: Discussionmentioning

confidence: 99%

“…15 It remains unknown whether patients with epilepsy have an increased risk of COVID-19 or developing more severe disease. 16,17 The aim of this study was to determine the incidence and fatality of COVID-19 among patients with active epilepsy compared with the general population, identify the main risk factors related to higher fatality in patients with active epilepsy, and analyze whether epilepsy is associated with fatality in hospitalized patients with COVID-19.…”

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confidence: 99%

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Incidence and case fatality rate of COVID-19 in patients with active epilepsy

et al. 2020

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OBJECTIVEThis article estimates the incidence and fatality of COVID-19 and identify potential risk factors to fatality in patients with active epilepsy.MATERIAL AND METHODSThis is a cross-sectional observational study of patients with active epilepsy and COVID-19. A control group was used to compare the cumulative incidence and case fatality rate (CFR). The main outcomes of the study were cumulative incidence, defined as number of patients with active epilepsy and COVID-19 admitted in emergency department divided by the total number of patients with epilepsy at risk; and CFR based on the number of deaths during the enrolment period. Multiple logistic regression analysis was performed to investigate risk factors for fatality in patients with active epilepsy.RESULTSOf the 1537 patients who fulfilled the inclusion criteria, 21 (1.3%) had active epilepsy. The cumulative incidence (95% CI) of COVID-19 in epilepsy patients was higher (1.2% [0.6-2.4]) compared to population without epilepsy (0.5% [0.5-0.5]). In RT-PCR positive patients there were no significant differences in CFR in patients with active epilepsy compared to patients without epilepsy (33.3% vs. 8.3%; p =0.266). Of the 21 active epilepsy patients, 5 (23%) died. In multivariate analysis, the factor associated with fatality in patients with active epilepsy was hypertension (OR [95%CI], 2.8 [1.3-21.6]). In other model age (OR [95%CI], 1.0 [1.0-1.1]) and epilepsy (OR [95%CI], 5.1 [1.3-24.0]) were associated with fatality during hospitalization.CONCLUSIONCOVID-19 cumulative incidence were higher in patients with active epilepsy. Epilepsy was associated with fatality during hospitalization. Hypertension was associated with fatality in patients with epilepsy.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Incidence and case fatality rate of COVID-19 in patients with active epilepsy

et al. 2020

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“…Patients have also been advised to avoid emergency room visits unless for life-threatening conditions. Different concerns regarding epilepsy and COVID-19 have been raised, yet current evidence suggests that PWE are not more likely to become infected with the virus and nor are they at higher risk of complications [6,7]. The concern, however, is that seizures may result in emergency room or clinical visits, and so better control of seizures is required.…”

Section: Introductionmentioning

confidence: 99%

The effect of COVID-19 pandemic on seizure control and self-reported stress on patient with epilepsy

Alkhotani

Siddiqui

Almuntashri

et al. 2020

Epilepsy & Behavior

111

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The objective of the study was to assess if patients with epilepsy (PWE) experienced an increase in seizure frequency and self-reported stress during the COVID-19 pandemic. Methods: This is a cross-sectional study conducted in Saudi Arabia in April 2020. An electronic self-administered questionnaire was distributed to PWE via their treating neurologist. The variables included were demographic and baseline clinical characteristics (age, gender, living situation, occupational status, type of epilepsy, duration of epilepsy, number of antiepileptic medications (AEDs), presence of known psychiatric illness, and use of psychiatric medications), their seizure control in the month prior to the pandemic, perceived stress during this period of time, sleep changes, compliance changes, and change in seizure control during the pandemic. Results: A total of 156 patients completed the questionnaire, with 29.5% reporting an increase in seizure frequency. Additionally, 59.4% reported an increase in self-reported stress and 71.2% experienced a significant change in their sleep during this period. Higher baseline seizure frequency, more AEDs, noncompliance, increase in self-reported stress, and sleep changes are the significant factors associated with increase in seizure frequency during the pandemic. Conclusion: Identifying high-risk patients for seizure recurrence is important in order to provide them with adequate support to reduce such risk.

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“…Likewise, comorbid SARS-CoV-2 infection can lead to higher rates of disability in acute neurological patients 9 . There is also an emerging concern on the potential negative impact of COVID-19 in the management of chronic neurological diseases such as Parkinson's disease 10 and epilepsy 11 .…”

Section: Introductionmentioning

confidence: 99%

Neurological consultations and diagnoses in a large, dedicated COVID-19 university hospital

Neto

Guedes

Tuma

et al. 2020

Arq. Neuro-Psiquiatr.

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Background: More than one-third of COVID-19 patients present neurological symptoms ranging from anosmia to stroke and encephalopathy. Furthermore, pre-existing neurological conditions may require special treatment and may be associated with worse outcomes. Notwithstanding, the role of neurologists in COVID-19 is probably underrecognized. Objective: The aim of this study was to report the reasons for requesting neurological consultations by internists and intensivists in a COVID-19-dedicated hospital. Methods: This retrospective study was carried out at Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil, a 900-bed COVID-19 dedicated center (including 300 intensive care unit beds). COVID-19 diagnosis was confirmed by SARS-CoV-2-RT-PCR in nasal swabs. All inpatient neurology consultations between March 23rd and May 23rd, 2020 were analyzed. Neurologists performed the neurological exam, assessed all available data to diagnose the neurological condition, and requested additional tests deemed necessary. Difficult diagnoses were established in consensus meetings. After diagnosis, neurologists were involved in the treatment. Results: Neurological consultations were requested for 89 out of 1,208 (7.4%) inpatient COVID admissions during that period. Main neurological diagnoses included: encephalopathy (44.4%), stroke (16.7%), previous neurological diseases (9.0%), seizures (9.0%), neuromuscular disorders (5.6%), other acute brain lesions (3.4%), and other mild nonspecific symptoms (11.2%). Conclusions: Most neurological consultations in a COVID-19-dedicated hospital were requested for severe conditions that could have an impact on the outcome. First-line doctors should be able to recognize neurological symptoms; neurologists are important members of the medical team in COVID-19 hospital care.

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Epilepsy and COVID-19: Associations and important considerations

Cited by 101 publications

References 19 publications

Incidence and case fatality rate of COVID-19 in patients with active epilepsy

Incidence and case fatality rate of COVID-19 in patients with active epilepsy

The effect of COVID-19 pandemic on seizure control and self-reported stress on patient with epilepsy

Neurological consultations and diagnoses in a large, dedicated COVID-19 university hospital

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