Risk of COVID‐19 infection and seizure exacerbation among patients with epilepsy during the peak of Omicron wave

Abstract

ObjectivesExisting data regarding the risk of COVID‐19 infection and its effects on seizure control in patients with epilepsy (PWE) are inconclusive. Our research aims to investigate the PWE who are susceptible to COVID‐19 and what factors contribute to seizure exacerbation.MethodsFrom Dec 28, 2022 to Feb 19, 2023, a cross‐sectional questionnaire survey among adult PWE was conducted. The demographics, epilepsy‐related information, COVID‐19‐related variables, and seizure outcomes after COVID‐19 infection were collected. Multivariate logistic analyses were performed to determine the risk factors associated with COVID‐19 infection and exacerbated seizures.ResultsOf 1557 PWE, 829 (53.2%) were infected with COVID‐19 and 136 (16.4%) developed seizure exacerbation after COVID‐19 infection. Overweight/obesity (OR 1.372, 95% CI 1.075–1.753, p = 0.011), immunocompromised (OR 3.301, 95% CI 1.093–9.974, p = 0.031), active epilepsy (OR 1.700, 95% CI 1.378–2.097, p < 0.001), and antiseizure medication (ASM) polytherapy (OR 1.314, 95% CI 1.065–1.621, p = 0.011) were associated with COVID‐19 infection. Active epilepsy (OR 4.696, 95% CI 2.568–8.586, p < 0.001) and fever‐associated seizures (OR 4.298, 95%CI 2.659–6.946, p < 0.001) were associated with seizure exacerbation.SignificancePWE with overweight/obesity, immunocompromised, active epilepsy, and ASM polytherapy were at higher risk of COVID‐19 infection. Once infected with COVID‐19, seizures were exacerbated in PWE with active epilepsy and fever‐associated seizures.Plain language summaryPatients with epilepsy (PWE) do not appear to be more susceptible to COVID‐19 infection than general population. Once infected with COVID‐19, 16.4% of PWE had seizure exacerbation. The PWE who have experienced seizures within the past 12 months before infection tend to contract COVID‐19 more often, and are more likely to experience seizure exacerbations following COVID‐19 infection.