Impact of COVID‐19 pandemic on epilepsy care in Japan: A national‐level multicenter retrospective cohort study

Abstract

Objective The impact of the coronavirus disease 2019 (COVID‐19) pandemic on epilepsy care across Japan was investigated by conducting a multicenter retrospective cohort study. Methods This study included monthly data on the frequency of (1) visits by outpatients with epilepsy, (2) outpatient electroencephalography (EEG) studies, (3) telemedicine for epilepsy, (4) admissions for epilepsy, (5) EEG monitoring, and (6) epilepsy surgery in epilepsy centers and clinics across Japan between January 2019 and December 2020. We defined the primary outcome as epilepsy center‐specific monthly data divided by the 12‐month average in 2019 for each facility. We determined whether the COVID‐19 pandemic‐related factors (such as year [2019 or 2020], COVID‐19 cases in each prefecture in the previous month, and a state of emergency) were independently associated with these outcomes. Results In 2020, the frequency of outpatient EEG studies (−10.7%, P < .001) and cases with telemedicine (+2608%, P = .031) were affected. The number of COVID‐19 cases was an independent associated factor for epilepsy admission (−3.75 × 10 −3 % per case, P < .001) and EEG monitoring (−3.81 × 10 −3 % per case, P = .004). Furthermore, a state of emergency was an independent factor associated with outpatient with epilepsy (−11.9%, P < .001), outpatient EEG (−32.3%, P < .001), telemedicine for epilepsy (+12,915%, P < .001), epilepsy admissions (−35.3%; P < .001), EEG monitoring (−24.7%: P < .001), and epilepsy surgery (−50.3%, P < .001). Significance We demonstrated the significant impact that the COVID‐19 pandemic had on epilepsy care. These results support those of previous studies and clarify the effect size of each pandemic‐related factor on epilepsy care.

Impact of COVID-19 Pandemic on the Care of People with Epilepsy and Predictors of Epilepsy Worsening: Aswan/Upper Egypt Hospital-based study

“…In a cross-sectional study of 255 consecutive patients assessed by telephone, Fonseca and colleagues (2020) found a signi cant difference in the prevalence of COVID-19 between people with worsening non-worsening epilepsy (75.6% and 23.7%, respectively, with p < 0.0001) [29]. Also, the rate of vaccination was signi cantly lower in people with worsening epilepsy than non-worsening epilepsy (39.5% versus 68.4% respectively) with P = 0.003, and this nding agrees with previous research that was conducted in Italy by Romozzi and colleaguesin 2022 [34], who studied the safety and tolerability of COVID- This study demonstrated that the COVID-19 pandemic resulted in delayed neurology appointments and more di culty going to the pharmacy and getting medication in worsening than non-worsening epilepsy, which is consistent with Albert and colleagues and Kuroda and colleagues [35,36] as well as reduced access to ASM [24]. The current study also found that work di culties were more pronounced among people with worsening epilepsy, consistent with a general effect of increased seizure rate on patients' daily activities.…”

On-scene time delays for epileptic seizures in emergencies during a social pandemic: A population-based study

“…These seizures were associated with higher patient age and a higher prevalence of altered consciousness compared to the pre-pandemic period. During the pandemic period, some societies recommended reducing in-person healthcare facility visits for PWE with stable seizures, which decreased outpatient visits and admissions in epilepsy centers [31] . Our results might indicate that PWE with non-life-threatening status but a need for medication avoided calls to EMS, as in another study on stroke patients [32] .…”