Is Covid-19 lockdown related to an increase of accesses for seizures in the emergency department? An observational analysis of a paediatric cohort in the Southern Italy

Abstract

Background The World Health Organization (WHO) declared a global pandemic of Covid-19 on 11 March 2020. The lockdown caused a lifestyle changes: an increase in the use of mobile media devices (MMDs), sleep and psychiatric disorders, incorrect habits regarding food and physical activities. We investigate prevalence of admission for seizures at our emergency department (ED), during Italian lockdown, comparing with that of the same period of the previous year (2019), and the relationship with some lifestyle changes. Methods In this observational study, patients (4–14 years) with seizures that accessed at our ED, during Italian lockdown, were eligible. Non-epileptic events and febrile seizures were excluded. We describe two groups: patients with new-onset seizures and not. Moreover, a questionnaire concerning use of MMDs and sleep habits was administered. Results Fifty-seven patients were included; median age 8.03 years. Considering only paediatric medical emergencies, the prevalence of accesses for seizures was 2.6% (CI 95% 0.020–0.034), while the incidence was 0.94% (CI 95% 0.006–0.0149). There was a statistically significant difference with prevalence of previous years, χ2 102.21 (p = 0.0001). We also reported a difference in daily screen time (DST) (p = 0.001) and total sleep time (TST) (p = 0.045), in all population, between period pre- and during lockdown. A negative correlation between DST and seizures latency (Spearman’s ρ -0.426, p = 0.038) was found. In the two groups, the results were partially overlapping. Conclusions During lockdown period, we assisted to an increase of accesses for seizures. It is conceivable that a sleep time change and/or higher MMD use could act as triggers for seizures.

Impact of lockdown and school closure on children’s health and well-being during the first wave of COVID-19: a narrative review

“… 30 An increase in the number of admissions due to seizures was found in an Italian children’s hospital. 32 In another Italian study, the mean paediatric ED daily consultations decreased from 326.3 (95% CI 299.9 to 352.7) in March–May 2019 to 101.4 (95% CI 77.9 to 124.9) in the same period in 2020 (p<0.001). 34 …”

“…Outcome measures Five studies addressed mental health, [19][20][21][22][23] three studies analysed physical activity and obesity, 18 24 25 three studies examined diabetes mellitus, [26][27][28] eight studies approached changes in the access and use of healthcare services, [29][30][31][32][33][34][35][36] while three studies analysed data regarding child abuse and violence. [37][38][39] Mental health One Australian study showed a significant increase in depressive symptoms and anxiety and a significant decrease in life satisfaction during school closure and lockdown, mainly in girls (table 1).…”

Impact of the COVID-19 Pandemic on Sedentary Time and Behaviour in Children and Adults: A Systematic Review and Meta-Analysis

“…There were 64 studies included within the review [ 18 , 20 , 21 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , …”

Medium‐term changes in patients with epilepsy during the COVID‐19 pandemic

“…Besides that, the pandemic and the consequent situation of lockdown have also caused changes in the lifestyle habits 7,8 such as sleep disorders 9 . Important efforts have been made in order to provide adequate care for neurological conditions, 10 such as the rapid development of telemedicine 11 .…”