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Leng X, Hu G, Wang X, Zhang Y, Guo Y, Song C, Yang F, Jiang W, Wang Y, Wang X. Risk of COVID-19 infection and seizure exacerbation among patients with epilepsy during the peak of Omicron wave. Epilepsia Open 2024; 9:1416-1425. [PMID: 38795316 PMCID: PMC11296108 DOI: 10.1002/epi4.12978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/07/2024] [Accepted: 05/12/2024] [Indexed: 05/27/2024] Open
Abstract
OBJECTIVES Existing 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. METHODS From 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. RESULTS Of 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. SIGNIFICANCE PWE 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 SUMMARY Patients 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.
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Affiliation(s)
- Xiuxiu Leng
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Gengyao Hu
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Xuan Wang
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Yingchi Zhang
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Yaomin Guo
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Changgeng Song
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Fang Yang
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Wen Jiang
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Yuanyuan Wang
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Xiaomu Wang
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
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Zhou X, Ding D, Wang W, Zhou D, Sander JW. Mortality of Epilepsy in Chinese Populations: A Comprehensive Review. Neuroepidemiology 2024:1-14. [PMID: 39074464 DOI: 10.1159/000540426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 07/02/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Premature mortality is a significant part of the epilepsy burden and may vary across populations, especially between high-income and lower- and middle-income countries. People with epilepsy in China are approximately a fifth of the global population with epilepsy. Previous studies were unlikely to represent the situation in China due to limitations in design, methods, sample size, follow-up time, and other inherent population heterogeneity. SUMMARY By summarising the evidence on the mortality characteristics in Chinese populations with epilepsy in the last 6 decades, we found a median mortality rate of 14.7 (6.8-74.4)/1,000 person-years and a median standardised mortality ratio (SMR) of 4.4 (2.6-12.9) in population-based studies, and a median mortality rate of 12.3 (9.5-101.5)/1,000 person-years and a median SMR of 3.0 (1.5-5.1) in hospital-based studies. Vascular diseases, complications of diabetes, and accidental injuries were the leading causes of death. Risk factors for mortality were reported as older age, male, longer duration, and higher frequency of seizures. Case fatality ratios of status epilepticus in adults were higher than in children, and both increased with follow-up time. Mortality in people with symptomatic epilepsy was high and varied across different primary diseases. KEY MESSAGES The highest mortality rate and sudden unexpected death in epilepsy (SUDEP) incidence were reported from the least developed areas in China. Accidental injuries were the most common causes of epilepsy-related deaths, while the incidence of SUDEP may be underestimated in Chinese populations. Further research is warranted to improve the understanding of premature mortality risk so that preventative measures can be introduced to improve the situation.
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Affiliation(s)
- Xiaowen Zhou
- Institute of Neurology, National Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China,
| | - Ding Ding
- Institute of Neurology, National Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenzhi Wang
- Beijing Neurosurgical Institute, Beijing, China
| | - Dong Zhou
- Department of Neurology, West of China Hospital, Sichuan University, Chengdu, China
| | - Josemir W Sander
- Department of Neurology, West of China Hospital, Sichuan University, Chengdu, China
- UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Chalfont St Peter, UK
- Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
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Jamora RDG, Jalipa FGU, Villanueva III EQ, Sy MCC, Espiritu AI, Anlacan VMM. Clinical outcomes of patients with seizure admitted for COVID-19: Findings from the Philippine CORONA study. Heliyon 2024; 10:e32461. [PMID: 38933946 PMCID: PMC11201110 DOI: 10.1016/j.heliyon.2024.e32461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 06/04/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
Objective Seizure is one of the neurologic manifestations of coronavirus disease 2019 (COVID-19) infection. There are few studies focused on the outcome of hospitalized patients with COVID-19 and seizure. Methods This was a subgroup analysis of patients with seizure based on a nationwide, multicenter, retrospective study of COVID-19 patients admitted in 37 hospitals in the Philippines. Results A total of 10,881 patients with COVID-19 infection were included. Among these, 27 (0.2 %) patients had pre-existing seizure/epilepsy and 125 (1.1 %) had new-onset seizure. The patients with pre-existing seizure/epilepsy had a mean age of 49 years and majority were males (63.0 %). The patients with new-onset seizure had a mean age of 57 years and majority were males (60.5 %). Among patients with pre-existing seizure/epilepsy, there were no significant differences in the proportion of severe/critical COVID-19 (p = 0.131), all-cause mortality (p = 0.177), full/partial neurologic recovery (p = 0.190), ventilator use (p = 0.106), length of intensive care unit stay (p = 0.276), and length of hospitalization (p = 0.591). Patients with new-onset seizure were 2.65 times more likely to have severe/critical COVID-19 infection (p < 0.001), 3.12 times more likely to die (p < 0.001), and 3.51 times more likely to require a ventilator (p < 0.001) than those without new-onset seizure. New-onset seizure, however, was not significantly associated with full/partial neurologic recovery (p = 0.184) and prolonged length of hospitalization (p = 0.050). Conclusion Severe/critical COVID-19 infection, higher mortality rate, and use of a ventilator were significantly higher among patients with new-onset seizure but not among patients with pre-existing seizure/epilepsy.
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Affiliation(s)
- Roland Dominic G. Jamora
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Section of Neurology, Department of Internal Medicine, Cardinal Santos Medical Center, San Juan City, Philippines
| | - Francis Gerwin U. Jalipa
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Emilio Q. Villanueva III
- Department of Pathology, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Marie Charmaine C. Sy
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Adrian I. Espiritu
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Veeda Michelle M. Anlacan
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Section of Neurology, Department of Internal Medicine, Cardinal Santos Medical Center, San Juan City, Philippines
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Delazer L, Pressler N, Balestrini S, Xiao F, Clayton LM, Anders‐Cannon J, Salvatierra R, Henry I, Sisodiya SM, Sander JW, Koepp MJ. COVID-19 response in a long-term care facility for people with epilepsy. Epilepsia Open 2024; 9:1059-1066. [PMID: 38593277 PMCID: PMC11145605 DOI: 10.1002/epi4.12940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/09/2024] [Accepted: 04/01/2024] [Indexed: 04/11/2024] Open
Abstract
OBJECTIVE To assess asymptomatic rates and severity of SARS-CoV-2 infection in people with epilepsy and their healthcare workers in a long-term care facility which had implemented weekly surveillance testing between April 2020 and June 2022. METHODS Questionnaires focused on objective and subjective COVID-19 symptoms for people with epilepsy residing in and their healthcare workers at the Chalfont Centre for Epilepsy in June 2022. Demographic information, comorbidities, and seizure frequency were gathered from medical records. We also collected responses on objective and subjective COVID-19 symptoms from healthcare workers who participated in a prospective study assessing the reaction to COVID-19 vaccinations (SAFER). RESULTS Fifty-five out of 89 (62%) residents tested positive at least once on weekly PCR testing for SARS-CoV-2 during the period of interest; 20 of those (37%) were asymptomatic. In comparison, of those 63 healthcare workers who tested positive at least once on weekly testing during the same period, only four (6%) were asymptomatic. Of the 159 healthcare workers who also participated in the SAFER study, 41 tested positive at least once, and seven (17%) were completely asymptomatic during infection with SARS-CoV-2. SIGNIFICANCE People with epilepsy living in a long-term care facility were more likely to present with asymptomatic SARS-CoV-2 infections than healthcare workers at the same facility. Despite possible bias in the reporting of subjective symptoms due to management-by-proxy, there is no evidence that vulnerable people living in an epilepsy long-term care facility showed reduced resilience towards infections. PLAIN LANGUAGE SUMMARY People with epilepsy living in care home facilities had a surprisingly high degree of asymptomatic infections with SARS-CoV-2. Very few residents had severe or fatal outcomes. This is in stark contrast to the widely reported bad outcomes for people without epilepsy in other care homes. People with epilepsy reported significantly less symptoms than their healthcare workers. No changes in seizure frequency during or after infection were observed.
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Affiliation(s)
- Luisa Delazer
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
- Department of Clinical & Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Department of Neurology, Epilepsy CenterLudwig Maximilians UniversityMunichGermany
| | - Noah Pressler
- University of Nottingham, Medical SchoolNottinghamUK
| | - Simona Balestrini
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
- Department of Clinical & Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Neuroscience Department, Children's Hospital A. Meyer IRCSSUniversity of FlorenceFlorenceItaly
| | - Fenglai Xiao
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
- Department of Clinical & Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
| | - Lisa M. Clayton
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
- Department of Clinical & Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
| | | | | | - Ian Henry
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
| | - Sanjay M. Sisodiya
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
- Department of Clinical & Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
| | - Josemir W. Sander
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
- Department of Clinical & Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
- Stichting Epilepsie Instellingen Nederland (SEIN)HeemstedeThe Netherlands
| | - Matthias J. Koepp
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
- Department of Clinical & Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
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Larrosa-García M, Garcia-Garcia S, Louro J, Sánchez-Montalvá A, Sampol Sirvent J, Augustín Recio S, Guillén Del Castillo A, Riera-Arnau J, Gorgas MQ, Miarons M. Use of chronic medications and risk of death due to COVID-19 in hospitalised patients. Eur J Hosp Pharm 2024; 31:247-252. [PMID: 36302612 DOI: 10.1136/ejhpharm-2021-003186] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 10/11/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES To evaluate the potential association between chronic exposure to medication and death related to COVID-19. METHODS This is a retrospective cross-sectional study that included all patients hospitalised due to COVID-19 from 11 March to 4 June 2020 in our centre. Chronic patient medication was classified by the Anatomical Therapeutic Chemical (ATC) classification; demographic and clinical data were analysed. Multivariate logistic regression models were used to estimate the adjusted odds ratios (aOR) of death for each drug exposure; each aOR represents an independent model adjusted by clinical factors related to COVID-19 mortality. RESULTS The study included 978 patients with a mean (SD) age of 64.5 (17.7) years who were predominantly male (531, 54.3%). Of all 978 patients, 182 (18.61%) died during the follow-up of the study. The most common Charlson Comorbidity Index (CCI) was 0, 4.2% were smokers, 16.7% were obese, 47.4% had hypertension, and 19.4% were diabetic. Most patients (70.8%) were prescribed at least one treatment, 32.5% used >5 treatments, and 8.6% >10. Our data suggest that COVID-19 hospitalised patients taking trimethoprim and analogues, leukotriene receptor antagonists, calcineurin inhibitors, aldosterone antagonists, selective immunosuppressants, propulsives, insulins and analogues, and benzodiazepine derivatives have a higher risk of death. CONCLUSIONS This study investigated the association between chronic exposure to drugs and the risk of death in COVID-19 patients. Our results have shed some light on the impact of chronic drug exposure on the risk of severe COVID-19; however, further research is needed to increase the understanding about its relevance.
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Affiliation(s)
| | | | - Javier Louro
- Department of Epidemiology and Evaluation, IMIM, Hospital del Mar INAD, Barcelona, Spain
| | | | | | | | | | - Judit Riera-Arnau
- Pharmacology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | - Marta Miarons
- Pharmacy Department, Vall d'Hebron University Hospital, Barcelona, Spain
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Zheng Q, Cheng YR, Wang M, Ma X, Ye L, Xu Z, Feng Z. COVID-19 vaccinations for patients with epilepsy in Guizhou Province, China: A cross-sectional study. Heliyon 2024; 10:e29354. [PMID: 38623193 PMCID: PMC11016729 DOI: 10.1016/j.heliyon.2024.e29354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/28/2024] [Accepted: 04/05/2024] [Indexed: 04/17/2024] Open
Abstract
Several COVID-19 vaccines have been approved for emergency use according to China's immunization programs. These vaccines has created hope for patients with epilepsy, because the vaccines can help to reduce their risk of becoming infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this study was to investigate the COVID-19 vaccine safety in patients with epilepsy. Here, we assessed the time of symptom control and the features of adverse events of seizure patients following their COVID-19 vaccinations. The results showed that adverse events of COVID-19 vaccinations for epilepsy patients included local pain at the injection site, dizziness and headache, epileptic attack, somnolence, limb weakness, limb pain, allergy, and fever. In addition, the average recovery time of the adverse events was approximately 42 h. More importantly, our study showed that it was relatively safe to vaccinate epilepsy patients who did not experience seizures for approximately 12 months prior to the immunization date.
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Affiliation(s)
- Qian Zheng
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
- School of clinical medicine, Guizhou Medical University, Guiyang, China
| | - Yong-Ran Cheng
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Mingwei Wang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Xuntai Ma
- Department of Neurology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Lan Ye
- School of Basic Medicine, Guizhou Medical University, Guiyang, China
| | - Zucai Xu
- Department of Neurology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Zhanhui Feng
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
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Delil MS, Turk BG, Kochan-Kizilkilic E, Abbaszade H, Yeni SN, Ozkara C. The effect of the coronavirus vaccinations on seizures in patients with epilepsy. Heliyon 2024; 10:e28337. [PMID: 38560696 PMCID: PMC10979212 DOI: 10.1016/j.heliyon.2024.e28337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 03/15/2024] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose Information on COVID-19 vaccine tolerance and complications in patients with epilepsy is not yet sufficient to provide a recommendation for vaccination guidelines. The aim of this study was to investigate the effect of two types of COVID vaccines currently used in Turkey (mRNA vaccine from Pfizer/BioNTech and inactivated vaccine from Sinovac) on epileptic seizures. Methods We included 318 patients with epilepsy who were admitted to our epilepsy outpatient clinic. Clinical characteristics such as age, gender, age at seizure onset and the duration of epilepsy were noted. Types and the numbers of the anti-seizure drugs were recorded. Patients were evaluated either by face-to-face or by teleconference interviews. The seizure frequency in the first thirty days after any dose of vaccination was questioned. Results A total of 318 patients (149 females, 46.8%) with a confirmed diagnosis of epilepsy were enrolled in the study. An increase in seizure frequency was reported after the COVID-19 vaccine in 19 patients. Of these 19 patients, 2 were vaccinated with Sinovac, while 17 were vaccinated with BioNTech/Pfizer mRNA vaccine. There was no significant relationship between age, age at seizure onset, duration of epilepsy, type of seizures, seizure frequency or seizure induction. Status epilepticus was not reported in any of the participants. Conclusion Physicians need strong scientific evidence to advocate the importance of vaccine for COVID-19, that's why accumulation of knowledge related to this issue is important not only from medical but also from medico-legal point of interest. We aimed to contribute the current literature with our study to strengthen the physicians' hand while recommending COVID vaccines to PWE. Our results show that there is no significant increase in the risk of triggering seizures with COVID-19 vaccines. These data show that vaccination against COVID-19 with both vaccine types in patients with epilepsy is safe and well tolerated.
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Affiliation(s)
- Memet Sakir Delil
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Bengi Gul Turk
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | | | - Hikmet Abbaszade
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Seher Naz Yeni
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Cigdem Ozkara
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Ufongene C, Van Hyfte G, Agarwal P, Goldstein J, Mathew B, Navis A, McCarthy L, Kwon CS, Gururangan K, Balchandani P, Marcuse L, Naasan G, Singh A, Young J, Charney A, Nadkarni G, Jette N, Blank LJ. Older adults with epilepsy and COVID-19: Outcomes in a multi-hospital health system. Seizure 2024; 114:33-39. [PMID: 38039805 PMCID: PMC10841585 DOI: 10.1016/j.seizure.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/26/2023] [Accepted: 11/24/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is associated with high rates of mortality and morbidity in older adults, especially those with pre-existing conditions. There is little work investigating how neurological conditions affect older adults with COVID-19. We aimed to compare in-hospital outcomes, including mortality, in older adults with and without epilepsy. METHODS This retrospective study in a large multicenter New York health system included consecutive older patients (age ≥65 years) either with or without epilepsy who were admitted with COVID-19 between 3/2020-5/2021. Epilepsy was identified using a validated International Classification of Disease (ICD) and antiseizure medicationbased case definition. Univariate comparisons were calculated using Chi-square, Fisher's exact, Mann-Whitney U, or Student's t-tests. Multivariable logistic regression models were generated to examine factors associated with mortality, discharge disposition and length of stay (LOS). RESULTS We identified 5384 older adults admitted with COVID-19 of whom 173 (3.21 %) had epilepsy. Mean age was significantly lower in those with (75.44, standard deviation (SD): 7.23) compared to those without epilepsy (77.98, SD: 8.68, p = 0.007). Older adults with epilepsy were more likely to be ventilated (35.84 % vs. 16.18 %, p < 0.001), less likely to be discharged home (21.39 % vs. 43.12 %, p < 0.001), had longer median LOS (13 days vs. 8 days, p < 0.001), and had higher in-hospital death (35.84 % vs. 28.29 %, p = 0.030) compared to those without epilepsy. Epilepsy in older adults was associated with increased odds of in-hospital death (adjusted odds ratio (aOR), 1.55; 95 % CI 1.12-2.14, p = 0.032), non-routine discharge disposition (aOR, 3.34; 95 % CI 2.21-5.03, p < 0.001), and longer LOS (46.46 % 95 % CI 34 %-59 %, p < 0.001). CONCLUSIONS In models that adjusted for multiple confounders including comorbidity and age, our study found that epilepsy was still associated with higher in-hospital mortality, longer LOS and worse discharge dispositions in older adults with COVID-19 higher in-hospital mortality, longer LOS and worse discharge dispositions in older adults with COVID-19. This work reinforces that epilepsy is a risk factor for worse outcomes in older adults admitted with COVID-19. Timely identification and treatment of COVID-19 in epilepsy may improve outcomes in older people with epilepsy.
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Affiliation(s)
- Claire Ufongene
- Icahn School of Medicine at Mount Sinai (ISMMS), New York, NY, United States
| | - Grace Van Hyfte
- Department of Neurology, ISMMS, New York, NY, United States; Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, NY, United States
| | - Parul Agarwal
- Department of Neurology, ISMMS, New York, NY, United States; Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, NY, United States
| | - Jonathan Goldstein
- Icahn School of Medicine at Mount Sinai (ISMMS), New York, NY, United States
| | - Brian Mathew
- Department of Neurology, ISMMS, New York, NY, United States
| | - Allison Navis
- Department of Neurology, ISMMS, New York, NY, United States
| | | | - Churl-Su Kwon
- Department of Neurology, Epidemiology, Neurosurgery and the Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States
| | | | - Priti Balchandani
- BioMedical Engineering and Imaging Institute, ISMMS, New York, NY, United States
| | - Lara Marcuse
- Department of Neurology, ISMMS, New York, NY, United States
| | - Georges Naasan
- Department of Neurology, ISMMS, New York, NY, United States
| | - Anuradha Singh
- Department of Neurology, ISMMS, New York, NY, United States
| | - James Young
- Department of Neurology, ISMMS, New York, NY, United States
| | | | | | - Nathalie Jette
- Department of Neurology, ISMMS, New York, NY, United States; Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, NY, United States; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Leah J Blank
- Department of Neurology, ISMMS, New York, NY, United States; Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, NY, United States.
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Rider F, Hauser WA, Yakovlev A, Shpak A, Guekht A. Incidence, severity and outcomes of COVID-19 in age and gender matched adults with and without epilepsy in Moscow: A historical cohort study. Seizure 2023; 112:32-39. [PMID: 37741151 DOI: 10.1016/j.seizure.2023.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 09/08/2023] [Accepted: 09/17/2023] [Indexed: 09/25/2023] Open
Abstract
OBJECTIVE We hypothesized that PWE have an increased risk to acquire COVID-19. This was a historical cohort study to determine COVID-19 incidence, severity, mortality and risk factors in adults with active epilepsy (PWE) compared to residents of Moscow without epilepsy matched by age, gender, and region of residence - Moscow Community Comparisons (MCC). METHODS Subjects were derived from a cohort of adult PWE and a cohort of age- and gender-matched population-based MCC without epilepsy identified in 2018. Incidence of COVID-19 was compared in each cohort from 01.03.2020 through 28.02.21. Influence of age, gender, comorbidities, and for the PWE cohort, epilepsy type, seizure frequency, and number/class of antiseizure medications was evaluated using Pearson's chi-squared test and logistic regression analysis. RESULTS We found 887 COVID-19 positive people in the two cohorts: 156 in PWE (51.8 ± 19.7 years) and 731 in MCC (52.0 ± 17.3 years,). COVID-19 incidence was lower in PWE: 13.8 % versus 18.7 % in MCC (p = 0.0002). In PWE no specific epilepsy related variables influenced incidence. Despite no difference in severity distribution in PWE versus MCC, hospitalization rate (37.6 % versus 25.5 %, p = 0.002), disease duration (57.1 % versus 47.1, p = 0.023), and mortality (10.9% versus 4.2 %, p = 0.0009) were significantly higher in PWE. Age and number of comorbidities significantly influenced COVID-19 incidence, severity, duration, and outcomes in both cohorts. SIGNIFICANCE Incidence of COVID-19 in PWE in Moscow was significantly lower compared to MCC. Age and comorbidities were strongly associated with severity, duration and outcomes of COVID-19 for all infected persons. Higher mortality in PWE may be explained by a higher number of comorbidities.
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Affiliation(s)
- Flora Rider
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russian Federation.
| | - W Allen Hauser
- Gertrude H. Sergievsky Center, Columbia University, New York, USA
| | - Alexander Yakovlev
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russian Federation; Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russian Federation
| | - Alexander Shpak
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russian Federation; The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Alla Guekht
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russian Federation; Pirogov Russian National Research Medical University, Moscow, Russian Federation
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10
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Ufongene C, Van Hyfte G, Agarwal P, Blank LJ, Goldstein J, Mathew B, Lin JY, Navis A, McCarthy L, Gururangan K, Peschansky V, Kwon CS, Cohen A, Chan AHW, Dhamoon M, Deng P, Gutzwiller EM, Hao Q, He C, Heredia Nunez WD, Klenofsky B, Lemus HN, Marcuse L, Roberts M, Schorr EM, Singh A, Tantillo G, Young J, Balchandani P, Festa J, Naasan G, Charney A, Nadkarni G, Jetté N. In-hospital outcomes in patients with and without epilepsy diagnosed with COVID-19-A cohort study. Epilepsia 2023; 64:2725-2737. [PMID: 37452760 DOI: 10.1111/epi.17715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 07/07/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES Coronavirus disease 2019 (COVID-19) is associated with mortality in persons with comorbidities. The aim of this study was to evaluate in-hospital outcomes in patients with COVID-19 with and without epilepsy. METHODS We conducted a retrospective study of patients with COVID-19 admitted to a multicenter health system between March 15, 2020, and May 17, 2021. Patients with epilepsy were identified using a validated International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)/ICD-10-CM case definition. Logistic regression models and Kaplan-Meier analyses were conducted for mortality and non-routine discharges (i.e., not discharged home). An ordinary least-squares regression model was fitted for length of stay (LOS). RESULTS We identified 9833 people with COVID-19 including 334 with epilepsy. On univariate analysis, people with epilepsy had significantly higher ventilator use (37.70% vs 14.30%, p < .001), intensive care unit (ICU) admissions (39.20% vs 17.70%, p < .001) mortality rate (29.60% vs 19.90%, p < .001), and longer LOS (12 days vs 7 days, p < .001). and fewer were discharged home (29.64% vs 57.37%, p < .001). On multivariate analysis, only non-routine discharge (adjusted odds ratio [aOR] 2.70, 95% confidence interval [CI] 2.00-3.70; p < .001) and LOS (32.50% longer, 95% CI 22.20%-43.60%; p < .001) were significantly different. Factors associated with higher odds of mortality in epilepsy were older age (aOR 1.05, 95% CI 1.03-1.08; p < .001), ventilator support (aOR 7.18, 95% CI 3.12-16.48; p < .001), and higher Charlson comorbidity index (CCI) (aOR 1.18, 95% CI 1.04-1.34; p = .010). In epilepsy, admissions between August and December 2020 or January and May 2021 were associated with a lower odds of non-routine discharge and decreased LOS compared to admissions between March and July 2020, but this difference was not statistically significant. SIGNIFICANCE People with COVID-19 who had epilepsy had a higher odds of non-routine discharge and longer LOS but not higher mortality. Older age (≥65), ventilator use, and higher CCI were associated with COVID-19 mortality in epilepsy. This suggests that older adults with epilepsy and multimorbidity are more vulnerable than those without and should be monitored closely in the setting of COVID-19.
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Affiliation(s)
- Claire Ufongene
- Icahn School of Medicine at Mount Sinai (ISMMS), New York, New York, USA
| | - Grace Van Hyfte
- Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, New York, USA
| | - Parul Agarwal
- Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, New York, USA
- Department of Neurology, ISMMS, New York, New York, USA
| | - Leah J Blank
- Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, New York, USA
- Department of Neurology, ISMMS, New York, New York, USA
| | - Jonathan Goldstein
- Icahn School of Medicine at Mount Sinai (ISMMS), New York, New York, USA
| | - Brian Mathew
- Department of Neurology, ISMMS, New York, New York, USA
| | - Jung-Yi Lin
- Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, New York, USA
| | - Allison Navis
- Department of Neurology, ISMMS, New York, New York, USA
| | | | | | - Veronica Peschansky
- Department of Neurology, ISMMS, New York, New York, USA
- Department of Neurology, Columbia University, New York, New York, USA
| | - Churl-Su Kwon
- Department of Neurology, Columbia University, New York, New York, USA
- Department of Neurosurgery, Epidemiology, and the Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA
| | - Ariella Cohen
- Icahn School of Medicine at Mount Sinai (ISMMS), New York, New York, USA
| | | | | | - Pojen Deng
- Department of Neurology, ISMMS, New York, New York, USA
| | | | - Qing Hao
- Department of Neurology, ISMMS, New York, New York, USA
| | - Celestine He
- Icahn School of Medicine at Mount Sinai (ISMMS), New York, New York, USA
| | | | | | | | - Lara Marcuse
- Department of Neurology, ISMMS, New York, New York, USA
| | | | - Emily M Schorr
- Division of Neuroimmunology and Neuroinfectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Gabriela Tantillo
- Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
| | - James Young
- Department of Neurology, ISMMS, New York, New York, USA
| | - Priti Balchandani
- BioMedical Engineering and Imaging Institute, ISMMS, New York, New York, USA
| | - Joanne Festa
- Department of Neurology, ISMMS, New York, New York, USA
- The Barbara and Maurice Deane Center for Wellness and Cognitive Health, Mount Sinai, New York, New York, USA
| | - Georges Naasan
- Department of Neurology, ISMMS, New York, New York, USA
- The Barbara and Maurice Deane Center for Wellness and Cognitive Health, Mount Sinai, New York, New York, USA
| | - Alexander Charney
- Department of Psychiatry, ISMMS, New York, New York, USA
- Department of Genetics and Genomic Sciences, ISMMS, New York, New York, USA
| | | | - Nathalie Jetté
- Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, New York, USA
- Department of Neurology, ISMMS, New York, New York, USA
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
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11
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Yuan Z, Shao Z, Ma L, Guo R. Clinical Severity of SARS-CoV-2 Variants during COVID-19 Vaccination: A Systematic Review and Meta-Analysis. Viruses 2023; 15:1994. [PMID: 37896770 PMCID: PMC10611048 DOI: 10.3390/v15101994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/11/2023] [Accepted: 09/23/2023] [Indexed: 10/29/2023] Open
Abstract
Due to the variation in the SARS-CoV-2 virus, COVID-19 exhibits significant variability in severity. This presents challenges for governments in managing the allocation of healthcare resources and prioritizing health interventions. Clinical severity is also a critical statistical parameter for researchers to quantify the risks of infectious disease, model the transmission of COVID-19, and provide some targeted measures to control the pandemic. To obtain more accurate severity estimates, including confirmed case-hospitalization risk, confirmed case-fatality risk, hospitalization-fatality risk, and hospitalization-ICU risk, we conducted a systematic review and meta-analysis on the clinical severity (including hospitalization, ICU, and fatality risks) of different variants during the period of COVID-19 mass vaccination and provided pooled estimates for each clinical severity metric. All searches were carried out on 1 February 2022 in PubMed for articles published from 1 January 2020 to 1 February 2022. After identifying a total of 3536 studies and excluding 3523 irrelevant studies, 13 studies were included. The severity results show that the Delta and Omicron variants have the highest (6.56%, 0.46%, 19.63%, and 9.06%) and lowest severities (1.51%, 0.04%, 6.01%, and 3.18%), respectively, according to the four clinical severity metrics. Adults over 65 have higher severity levels for all four clinical severity metrics.
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Affiliation(s)
- Zhilu Yuan
- School of Architecture and Urban Planning, Research Institute for Smart Cities, Shenzhen University, Shenzhen 518060, China; (Z.Y.); (R.G.)
| | - Zengyang Shao
- College of Computer Science and Software Engineering, Shenzhen University, Shenzhen 518060, China;
| | - Lijia Ma
- College of Computer Science and Software Engineering, Shenzhen University, Shenzhen 518060, China;
| | - Renzhong Guo
- School of Architecture and Urban Planning, Research Institute for Smart Cities, Shenzhen University, Shenzhen 518060, China; (Z.Y.); (R.G.)
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12
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You M, Yuan P, Li L, Li B, Peng Z, Xu H. The association between epilepsy and COVID-19: analysis based on Mendelian randomization and FUMA. Front Neurosci 2023; 17:1235822. [PMID: 37781245 PMCID: PMC10540302 DOI: 10.3389/fnins.2023.1235822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
Objective A multitude of observational studies have underscored a substantial comorbidity between COVID-19 and epilepsy. This study was aimed at establishing a conclusive causal link between these two conditions. Methods We employed Mendelian randomization (MR) to evaluate the causal link between COVID-19 and epilepsy, as well as its focal and generalized subtypes. The GWAS for epilepsy and its subtypes database were abstracted from both FinnGen consortium and ILAE. Additionally, we leveraged functional mapping and annotation (FUMA) to integrate information from genome-wide association studies (GWAS) results. Results The MR analyses revealed that genetic liability to COVID-19 infection conferred a causal effect on epilepsy [FinnGen: OR: 1.5306; 95% confidence interval (CI): 1.1676-2.0062, PFDR (false discovery rate) = 0.0076; ILAE: OR: 1.3440; 95% CI: 1.0235-1.7649, PFDR = 0.0429], and generalized epilepsy (FinnGen: OR: 2.1155; 95% CI: 1.1734-3.8139, PFDR = 0.0327; ILAE: OR: 1.1245; 95% CI: 1.0444-1.2108, PFDR = 0.0114). Genetic liability to COVID-19 hospitalization conferred a causal effect on epilepsy (FinnGen: OR: 1.0934; 95% CI: 1.0097-1.1841, PFDR = 0.0422; ILAE: OR: 1.7381; 95% CI: 1.0467-2.8862, PFDR = 0.0451), focal epilepsy (ILAE: OR: 1.7549; 95% CI: 1.1063-2.7838, PFDR = 0.0338), and generalized epilepsy (ILAE: OR: 1.1827; 95% CI: 1.0215-1.3693, PFDR = 0.0406). Genetic liability to COVID-19 severity conferred a causal effect on epilepsy (FinnGen consortium: OR: 1.2454; 95% CI: 1.0850-1.4295, PFDR = 0.0162; ILAE: OR: 1.2724; 95% CI: 1.0347-1.5647, PFDR = 0.0403), focal epilepsy (FinnGen: OR: 1.6818; 95% CI: 1.1478-2.4642, PFDR = 0.0231; ILAE: OR: 1.6598; 95% CI: 1.2572-2.1914, PFDR = 0.0054), and generalized epilepsy (FinnGen: OR: 1.1486; 95% CI: 1.0274-1.2842, PFDR = 0.0335; ILAE: OR: 1.0439; 95% CI: 1.0159-1.0728, PFDR = 0.0086). In contrast, no causal linkage of epilepsy on COVID-19 was observed. Further, FUMA analysis identified six overlapping genes, including SMEK2, PNPT1, EFEMP1, CCDC85A, VRK2, and BCL11A, shared between COVID-19 and epilepsy. Tissue-specific expression analyses revealed that the disease-gene associations of COVID-19 were significantly enriched in lung, ovary, and spleen tissue compartments, while being significantly enriched in brain tissue for epilepsy. Conclusion Our study demonstrates that COVID-19 can be a contributing factor to epilepsy, but we found no evidence that epilepsy contributes to COVID-19.
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Affiliation(s)
| | | | | | | | | | - Hongbei Xu
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
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13
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Yang Y, Lv J, He C, Shen C, Xu S, Guo Y, Ding Y, Zheng Z, Zhu J, Wang S, Ding M, Wang S. Predictors and prevalence of COVID-19 vaccination in patients with focal epilepsy following resection surgery. Epilepsy Behav 2023; 145:109344. [PMID: 37459719 DOI: 10.1016/j.yebeh.2023.109344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND AND PURPOSE In light of the ongoing COVID-19 pandemic, vaccination has emerged as the primary and most effective solution. The aim of this study was to examine compliance rates of vaccination and explore the factors that predict vaccine uptake among patients with epilepsy (PWE) who have undergone resection surgery. METHOD To examine the variations in vaccination coverage, safety concerns, and factors influencing vaccination hesitancy among PWE who have undergone resection surgery, this study recruited patients with at least one-year follow-up. We utilized questionnaires to gather clinical characteristics and obtain information regarding COVID-19 vaccines. RESULTS Among the 303 patients included in the study, a majority of 229 (75.58%) achieved a seizure-free outcome (Engel Ia). Of these patients, 178 (58.75%) received at least one dose of COVID-19 vaccine, and the vaccination rate has remained relatively consistent over the past six months. Nearly 94.95% of those who received the vaccine completed the full vaccination regimen, with the majority (n = 174, 97.75%) opting for an inactivated vaccine. Only three patients reported side effects unrelated to epilepsy, and one patient experienced a worsening of typical aura seizures within one month after vaccination. Notably, significant positive associations were observed between COVID-19 vaccine acceptance and adulthood (age 18 years or older) (OR = 1.820, 95% CI = 1.018-3.252, p = 0.043) as well as achieving a seizure-free outcome (OR = 2.823, 95% CI = 1.619-4.921, p < 0.001). Regarding the unvaccinated patients, approximately one-fifth expressed willingness to receive a future COVID-19 vaccine, while the remainder were hesitant (41.60%) or unsure (39.20%) about vaccination. These reservations mainly stemmed from concerns about the potential worsening of seizures and vaccine safety. CONCLUSIONS Inactivated vaccines can be considered safe for individuals with epilepsy who have undergone resection surgery. The likelihood of being vaccinated was found to be comparatively higher among the cohort with seizure-free status or adults. To promote COVID-19 vaccination among children, it is crucial to implement comprehensive education and public awareness campaigns that emphasize the safety of vaccines. These efforts will help encourage widespread acceptance of vaccination and ensure the well-being of individuals with epilepsy.
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Affiliation(s)
- Yuyu Yang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jin Lv
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chenmin He
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chunhong Shen
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Sha Xu
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yi Guo
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yao Ding
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhe Zheng
- Epilepsy Center, Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Junming Zhu
- Epilepsy Center, Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuang Wang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Meiping Ding
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Shan Wang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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14
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Li X, Sun S, Yan C, Liu X. Interaction between COVID-19 and epilepsy during the omicron surge: A cross-sectional survey conducted in China tertiary hospital. Epilepsy Behav Rep 2023; 23:100613. [PMID: 37501889 PMCID: PMC10368756 DOI: 10.1016/j.ebr.2023.100613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 07/29/2023] Open
Abstract
Objective It is unclear whether patients with epilepsy are more susceptible to SARS-CoV-2 infection, whether they experience more severe manifestations of COVID-19, and whether seizures worsen after SARS-CoV-2 infection. Our study aims to explore these points and provide comprehensive and practical guidance for patients with epilepsy. Methods We designed a questionnaire to collect variables from epilepsy patients. We used the Chi-square test, Fisher's exact test, or Mann-Whitney U test to analyze differences between the two groups. Multiple logistic regressions were employed to determine the risk factors for relevant outcome variables. Results We identified a total of 181 patients, with 74% (n = 134) reporting COVID-19. The patients' educational level was found to be a risk factor for COVID-19 (OR = 0.33, 95% CI 0.14-0.80, P = 0.013). When comparing seizure frequency changes between epilepsy patients with and without COVID-19, no statistically significant difference was observed (P > 0.05). However, an increase in seizure frequency was significantly associated with higher levels of anxiety (P < 0.001) and depression (P < 0.005). Conclusion The risk of COVID-19 infection may be increased in patients with epilepsy. COVID-19 infection does not seem to worsen seizures in epilepsy patients. Patients with epilepsy rarely develop more severe clinical manifestations of COVID-19 after SARS-CoV-2 infection. During the COVID-19 pandemic, patients with epilepsy who also suffer from anxiety and depression may experience an increase in the frequency of their seizures.
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Affiliation(s)
- Xiangliang Li
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, China
| | - Sujuan Sun
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, China
| | - Cuihua Yan
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, China
| | - Xuewu Liu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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15
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Seyedhosseinzadeh N, Saeedi N, Hashemi A, Homam SM. Alterations in Seizure Frequency in Patients with Epilepsy Following Coronavirus Disease 2019. J Epilepsy Res 2023; 13:7-12. [PMID: 37720679 PMCID: PMC10501815 DOI: 10.14581/jer.23002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 04/30/2023] [Accepted: 05/08/2023] [Indexed: 09/19/2023] Open
Abstract
Background and Purpose During the coronavirus disease 19 (COVID-19) pandemic, a considerable number of studies have focused on the difficulties for accessing the medical services and telemedicine-related issues. However, it is not clear whether COVID-19 affects the clinical course of epilepsy. Therefore, in the current study we aimed to assess the effects of COVID-19 infection on seizure frequency in patients with epilepsy (PWE). Methods We evaluated PWE who consecutively referred to the neurology clinics of 22 Bahman and Qaem hospitals, who had experienced a recent polymerase chain reaction-confirmed-COVID-19 infection. Data were collected through a pre-defined electronic questionnaire. Results A total of 104 patients were included. Females represented 52% of the population. The mean age of the patients was 36.73±17.87. Thirty-six patients (34%) reported increased seizure frequency. The mean age of the patients who had exacerbated seizure frequency was significantly lower than the non-exacerbated group (27.50±9.8 vs. 40.14±18.39; p=0.005). The number of the male patients were significantly higher in the exacerbated group (52% vs. 25%; p=0.014). The majority of exacerbated group had a history of drug resistance (44.4% vs. 8.5%; p=0.022). The number of epileptic seizures before COVID-19 infection was higher in the exacerbated (p=0.04). Conclusions About 34% of PWE experienced exacerbated epileptic seizures after COVID-19 infection. Male patients, young patients, patients with the history of drug resistance, and the patients who had higher seizure frequency were at increased risk for seizure exacerbation. Our results highlight the importance of screening, early diagnosis, and treatment in PWE.
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Affiliation(s)
| | - Nikoo Saeedi
- Student Research Committee, Islamic Azad University, Mashhad Branch, Mashhad, Iran
| | - Anahita Hashemi
- Student Research Committee, Islamic Azad University, Mashhad Branch, Mashhad, Iran
| | - Seyed Mehran Homam
- Department of Neurology, Islamic Azad University, Mashhad Branch, Mashhad, Iran
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16
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Mbizvo GK, Schnier C, Ramsay J, Duncan SE, Chin RF. Epilepsy-related mortality during the COVID-19 pandemic: A nationwide study of routine Scottish data. Seizure 2023; 110:160-168. [PMID: 37393862 PMCID: PMC10257947 DOI: 10.1016/j.seizure.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/25/2023] [Accepted: 06/11/2023] [Indexed: 07/04/2023] Open
Abstract
OBJECTIVE To examine whether epilepsy-related deaths increased during the COVID-19 pandemic and if the proportion with COVID-19 listed as the underlying cause is different between people experiencing epilepsy-related deaths and those experiencing deaths unrelated to epilepsy. METHODS This was a Scotland-wide, population-based, cross-sectional study of routinely-collected mortality data pertaining to March-August of 2020 (COVID-19 pandemic peak) compared to the corresponding periods in 2015-2019. ICD-10-coded causes of death of deceased people of any age were obtained from a national mortality registry of death certificates in order to identify those experiencing epilepsy-related deaths (coded G40-41), deaths with COVID-19 listed as a cause (coded U07.1-07.2), and deaths unrelated to epilepsy (death without G40-41 coded). The number of epilepsy-related deaths in 2020 were compared to the mean observed through 2015-2019 on an autoregressive integrated moving average (ARIMA) model (overall, men, women). Proportionate mortality and odds ratios (OR) for deaths with COVID-19 listed as the underlying cause were determined for the epilepsy-related deaths compared to deaths unrelated to epilepsy, reporting 95% confidence intervals (CIs). RESULTS A mean number of 164 epilepsy-related deaths occurred through March-August of 2015-2019 (of which a mean of 71 were in women and 93 in men). There were subsequently 189 epilepsy-related deaths during the pandemic March-August 2020 (89 women, 100 men). This was 25 more epilepsy-related deaths (18 women, 7 men) compared to the mean through 2015-2019. The increase in women was beyond the mean year-to-year variation seen in 2015-2019. Proportionate mortality with COVID-19 listed as the underlying cause was similar between people experiencing epilepsy-related deaths (21/189, 11.1%, CI 7.0-16.5%) and deaths unrelated to epilepsy (3,879/27,428, 14.1%, CI 13.7-14.6%), OR 0.76 (CI 0.48-1.20). Ten of 18 excess epilepsy-related deaths in women had COVID-19 listed as an additional cause. CONCLUSIONS There is little evidence to suggest there have been any major increases in epilepsy-related deaths in Scotland during the COVID-19 pandemic. COVID-19 is a common underlying cause of both epilepsy-related and unrelated deaths.
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Affiliation(s)
- Gashirai K Mbizvo
- Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, United Kingdom; Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom.
| | - Christian Schnier
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Julie Ramsay
- Vital Events Statistics, National Records of Scotland, Edinburgh, United Kingdom
| | - Susan E Duncan
- Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, United Kingdom; Department of Clinical Neurosciences, Edinburgh Royal Infirmary, Edinburgh, United Kingdom
| | - Richard Fm Chin
- Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, United Kingdom; Royal Hospital for Children and Young People, Edinburgh, United Kingdom
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17
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Wang Z, Fang X, Han T, Lv S, Li C, Ma A, Jiang Z, Li W, Sun W, Sun W, Gao Y, Gao Z, Liu Y, Li Q, Wang S, Li B, Liu X, Liu X. Safety and Tolerability of COVID-19 Vaccine in Children With Epilepsy: A Prospective, Multicenter Study. Pediatr Neurol 2023; 140:3-8. [PMID: 36577181 PMCID: PMC9721163 DOI: 10.1016/j.pediatrneurol.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND We designed this study to investigate the effects of the coronavirus disease 2019 (COVID-19) vaccine on epileptic seizures, as well as its adverse effects, in children with epilepsy (<18 years). METHODS This anonymous questionnaire study involved a multicenter prospective survey of outpatients and inpatients with epilepsy (<18 years) registered in epilepsy clinics in eight hospitals in six cities of Shandong Province. RESULTS A total of 224 children with epilepsy were included in the study. Fifty of them experienced general adverse events after vaccination. The most common local adverse events were pain or tenderness at the injection site. The most common systemic adverse effects were muscle soreness and headache. No severe adverse events were reported. There were no significant differences in the number of antiseizure medications (P = 0.459), gender (P = 0.336), etiology (P = 0.449), age (P = 0.499), duration of disease (P = 0.546), or seizure type (P = 0.475) between the patients with and without general adverse events. We found that the risk of seizure after vaccination was decreased in children who were seizure free for more than six months before vaccination. There was no significant difference in the number of seizures during the first month before vaccination, the first month after the first dose, and the first month after the second dose (P = 0.091). CONCLUSION The benefits of vaccination against COVID-19 outweighed the risks of seizures/relapses and severe adverse events after vaccination for children with epilepsy.
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Affiliation(s)
- Zhihao Wang
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, China
| | - Xiqin Fang
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, China
| | - Tao Han
- Department of Neurology, Shandong Provincial Hospital, Jinan, China
| | - Shishen Lv
- Department of Pediatrics, Tengzhou Central People's Hospital, Tengzhou, China
| | - Chunxiang Li
- Department of Pediatrics, Yantai Yuhuangding Hospital, Yantai, China
| | - Aihua Ma
- Department of Pediatrics, Shandong Provincial Hospital, Jinan, China
| | - Zhaolun Jiang
- Department of Pediatrics, Tengzhou Central People's Hospital, Tengzhou, China
| | - Wenke Li
- Department of Pediatrics, Tengzhou Central People's Hospital, Tengzhou, China
| | - Wenxiu Sun
- Department of Pediatrics, Shandong Provincial Hospital, Jinan, China
| | - Wenying Sun
- Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, China
| | - Yuxing Gao
- Department of Pediatrics, Shandong Provincial Hospital, Jinan, China
| | - Zaifen Gao
- Department of Pediatrics, Qilu Children's Hospital of Shandong University, Jinan, China
| | - Yong Liu
- Department of Pediatrics, Qilu Children's Hospital of Shandong University, Jinan, China
| | - Qiubo Li
- Department of Neurology, Affiliated Hospital of Jining Medical, Jining, China
| | - Suli Wang
- Department of Pediatrics, Weifang Maternal and Child Health Care Hospital, Weifang, China
| | - Baomin Li
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Xinjie Liu
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Xuewu Liu
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, China; Institute of Epilepsy, Shandong University, Jinan, China.
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18
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Ong MJY, Khoo CS, Lee YX, Poongkuntran V, Tang CK, Choong YJ, Hod R, Tan HJ. Safety and adverse events following COVID-19 vaccination among people with epilepsy: A cross-sectional study. Epilepsia Open 2023; 8:60-76. [PMID: 36214033 PMCID: PMC9874900 DOI: 10.1002/epi4.12658] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/05/2022] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Epilepsy is a non-communicable disease costing a massive burden globally. It is known that there is increased prevalence of morbidity and mortality following COVID-19 infection among people with epilepsy (PWE). However, there is limited information about the adverse events following COVID-19 immunization among PWE. Hence, this study aimed to assess the safety and adverse events following immunization (AEFI) of various COVID-19 vaccines among PWE from our centre, focusing on neurological AEFI. METHODS This cross-sectional study recruited 120 adult PWE from the Neurology Clinic of the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Consent-taking was conducted via synchronous or asynchronous approaches, followed by a phone call interview session. The interview collected socio-demographic information, epilepsy-related variables, and vaccination-related variables. Univariate analysis and multiple logistic regression analysis were done to confirm factors associated with the AEFI of COVID-19 vaccination. RESULTS Among all types of COVID-19 vaccines, most of the PWE received the Cominarty® COVID-19 vaccination (52.5%). Overall, local AEFI was the quickest to develop, with an average onset within a day. PWE with normal body mass index (BMI) had a higher risk of developing both local and systemic AEFI compared to those underweight and obese PWE (OR: 15.09, 95% CI 1.70-134.28, P = 0.02). SIGNIFICANCE COVID-19 vaccines are safe for PWE. AEFI among PWE are similar to those of the general population following COVID-19 vaccination. Therefore, clinicians should encourage PWE to take COVID-19 vaccines.
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Affiliation(s)
- Marjorie Jia Yi Ong
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.,Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Ching Soong Khoo
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Yi Xuan Lee
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Vaanee Poongkuntran
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Chia Khoi Tang
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Yu Joe Choong
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Rozita Hod
- Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Hui Jan Tan
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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19
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Slonkova J, Chudy M, Togtokhjargal A, Tomaskova H, Vacovska H, Rytirova G, Dolezalova I. The effects of COVID-19 on sleep and general health of Czech patients with epilepsy. Heliyon 2023; 9:e13413. [PMID: 36816256 PMCID: PMC9918435 DOI: 10.1016/j.heliyon.2023.e13413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/14/2022] [Accepted: 01/30/2023] [Indexed: 02/13/2023] Open
Abstract
Objectives To assess the impact of COVID-19 illness and pandemic era on sleep, general health, health care, and social status in patients with epilepsy in the Czech Republic. Methods Our designed and approved questionnaire consisted of 23 questions. We focused on (1) patients' demographic and epidemiological data regarding COVID-19, (2) subjective assessment of sleep; (3) epilepsy, and (4) perception of general health during the first year of the COVID-19 pandemic in the Czech Republic from March 2020 to May 2021. We administered the questionnaires during outpatient visits or by phone calls in three major university Czech epilepsy centers (Ostrava, Brno, Pilsen). Results We enrolled 227 (100%) patients. The mean age (±SD) was 41.2 ± 14.82 years (min 18, max 86 years), and 138 (61%) were women. COVID-19 was confirmed using the PCR test method in 57 (25.1%) patients. In the pre-pandemic era, 62 (27.3%) patients reported sleep disturbances. Insomnia in 46 (74.2%) and excessive daytime sleepiness in 6 (9.7%) were the most mentioned sleep abnormalities. Nocturnal seizures predispose to sleep impairment (p = 0.014) and vivid dreams and nightmares (p = 0.033). COVID-19 infection significantly increased the risk of vivid dreams and nightmares in patients with diurnal seizures (p = 0.006). Sleep quality impairment and seizure frequency worsening [(p < 0.001) and (p = 0.001), respectively] were the most significant risk factors to perform general health deterioration regardless of having COVID-19 (p = 0.559). The most affected age group was 51+ years (p = 0.033). The three centers provided adequate outpatient care during the first year of the pandemic. The employment and social status of the patients remained unchanged (p = 0.074). Conclusions COVID- 19 infection significantly increased the occurrence of vivid dreams and nightmares in patients with diurnal seizures. Sleep quality deterioration and seizure frequency worsening significantly negatively impacted general health performance.
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Affiliation(s)
- Jana Slonkova
- Department of Neurology, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava- Poruba, Czech Republic,Center of Clinical Neurosciences, Faculty of Medicine University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic,Corresponding author. Department of Neurology, University Hospital Ostrava, 17 listopadu 1790, 70852, Ostrava- Poruba, Czech Republic, ,
| | - Milos Chudy
- Center of Clinical Neurosciences, Faculty of Medicine University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic,Department of Epidemiology and Public Health, Faculty of Medicine University of Ostrava, Syllabova 19, Ostrava, Czech Republic
| | - Ariunjargal Togtokhjargal
- Department of Neurology, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava- Poruba, Czech Republic,Center of Clinical Neurosciences, Faculty of Medicine University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic
| | - Hana Tomaskova
- Department of Epidemiology and Public Health, Faculty of Medicine University of Ostrava, Syllabova 19, Ostrava, Czech Republic
| | - Hana Vacovska
- Department of Neurology, University Hospital Pilsen, E. Benese 1128, Pilsen 3, Czech Republic,Faculty of Medicine in Pilsen Charles University in Prague, Husova 3, Pilsen 3, 306 05, Czech Republic
| | - Gisela Rytirova
- Department of Neurology, University Hospital Pilsen, E. Benese 1128, Pilsen 3, Czech Republic,Faculty of Medicine in Pilsen Charles University in Prague, Husova 3, Pilsen 3, 306 05, Czech Republic
| | - Irena Dolezalova
- First Department of Neurology, St. Anne′s University Hospital Brno, Pekarska 53, 656 91 Brno, Czech Republic,Faculty of Medicine Masaryk University Brno, Kamenice 5, 625 00 Bohunice, Czech Republic
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20
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Pang EW, Lawn ND, Chan J, Lee J, Dunne JW. COVID-19 vaccination-related exacerbation of seizures in persons with epilepsy. Epilepsy Behav 2023; 138:109024. [PMID: 36495798 PMCID: PMC9705196 DOI: 10.1016/j.yebeh.2022.109024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 11/17/2022] [Accepted: 11/23/2022] [Indexed: 11/30/2022]
Abstract
Although vaccines are generally safe in persons with epilepsy (PWE), seizures can be associated with vaccination, including COVID-19. This study assessed the occurrence of COVID-19 vaccination-related seizure exacerbations in PWE. Adult PWE who had received a COVID-19 vaccine were consecutively recruited at a tertiary epilepsy clinic between June 2021 and April 2022. Patient demographics, including epilepsy history, vaccination details, and reported adverse effects were recorded. Seizure exacerbation, defined as occurring within one week of vaccination, was assessed. Five hundred and thirty PWE received the COVID-19 vaccine. 75 % received the Comirnaty (Pfizer) vaccine as their initial dose. Most patients (72 %) were taking ≥ 2 antiseizure medications (ASM) and had focal epilepsy (73 %). One-third were 12 months seizure free at their first vaccination. 13 patients (2.5 %) reported a seizure exacerbation following their first vaccination, three of whom required admission. None were seizure-free at baseline. Six of these patients (46 %) had a further exacerbation of seizures with their second vaccine. An additional four patients reported increased seizures only with the second vaccine dose. Seizure exacerbations are infrequently associated with COVID-19 vaccination, mainly in patients with ongoing seizures. The likelihood of COVID-19 infection complications in PWE outweighs the risk of vaccination-related seizure exacerbations.
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Affiliation(s)
- E W Pang
- Western Australian Adult Epilepsy Service, Perth, Western Australia, Australia; Neurology Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
| | - N D Lawn
- Western Australian Adult Epilepsy Service, Perth, Western Australia, Australia; Neurology Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - J Chan
- Western Australian Adult Epilepsy Service, Perth, Western Australia, Australia; Neurology Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - J Lee
- Western Australian Adult Epilepsy Service, Perth, Western Australia, Australia
| | - J W Dunne
- Western Australian Adult Epilepsy Service, Perth, Western Australia, Australia; Discipline of Internal Medicine, Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, Western Australia, Australia
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21
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Wang S, Lv J, He C, Yang Y, Zheng Y, Ye L, Chen C, Shen C, Xu S, Ding Y, Guo Y, Tang Y, Wang S, Ding M. COVID-19 vaccination hesitancy and safety among adult people with epilepsy in eastern China. Epilepsy Behav 2023; 138:108984. [PMID: 36423385 PMCID: PMC9637523 DOI: 10.1016/j.yebeh.2022.108984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 10/28/2022] [Accepted: 10/29/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study assesses the hesitancy and safety of vaccination administration for the novel 2019 Coronavirus Disease (COVID-19) among adult people with epilepsy (PWE). METHODS We recruited adult PWE who visited the outpatient epilepsy clinic from August 2021 to February 2022. We administered a structured questionnaire and a face-to-face interview regarding demographic factors, epilepsy characteristics, and relevant vaccine issues to all patients. Factors related to receiving a vaccine and epilepsy-related events after vaccination were then analyzed. RESULTS A total of 501 PWE were surveyed; 288 were unvaccinated and 213 were vaccinated. Patients without jobs (OR: 0.59; 95% CI: 0.37-0.95, p = 0.03) were less likely to receive the vaccine compared to students or those with jobs. Other factors associated with vaccination were a higher number of anti-seizure medications (OR: 0.72; 95% CI: 0.55-0.95, p = 0.02) and a lower pre-vaccine seizure frequency (OR: 2.21; 95% CI: 1.06-4.59, p = 0.03). Of the 213 vaccinated patients, 10 (4.70%) reported at least one local and/or systemic side effect. Most patients (92.50%) did not report worse seizures within one month of vaccination. Poor ASM adherence (OR: 15.06; 95% CI: 1.75-129.87, p = 0.01) and fatigue/stimulant drinks such as caffeine (OR: 50.59; 95% CI: 7.57-337.94, p < 0.01) were significantly associated with seizure worsening within one month of receiving the COVID-19 vaccination. CONCLUSION Almost two-fifths of patients with adult PWE have received a COVID-19 vaccine. Attention should be paid to educating epilepsy patients without jobs on the significance and safety of the vaccine. There was a low risk of seizure worsening in the short term after vaccination in PWE.
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Affiliation(s)
- Shan Wang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jin Lv
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chenmin He
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuyu Yang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuanyuan Zheng
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lingqi Ye
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Cong Chen
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chunhong Shen
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Sha Xu
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yao Ding
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yi Guo
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yelei Tang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuang Wang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Meiping Ding
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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22
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Lasalvia P, Trama A, Botta L, Franchi M, Bernasconi A. Developing a comorbidity score in cancer patients using healthcare utilization databases during the COVID-19 pandemic: An experience from Italy. Cancer Med 2022; 12:9849-9856. [PMID: 36540941 PMCID: PMC9877744 DOI: 10.1002/cam4.5540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/30/2022] [Accepted: 12/03/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND A strong relationship has been observed between comorbidities and the risk of severe/fatal COVID-19 manifestations, but no score is available to evaluate their association in cancer patients. To make up for this lacuna, we aimed to develop a comorbidity score for cancer patients, based on the Lombardy Region healthcare databases. METHODS We used hospital discharge records to identify patients with a new diagnosis of solid cancer between February and December 2019; 61 comorbidities were retrieved within 2 years before cancer diagnosis. This cohort was split into training and validation sets. In the training set, we used a LASSO-logistic model to identify comorbidities associated with the risk of developing a severe/fatal form of COVID-19 during the first pandemic wave (March-May 2020). We used a logistic model to estimate comorbidity score weights and then we divided the score into five classes (<=-1, 0, 1, 2-4, >=5). In the validation set, we assessed score performance by areas under the receiver operating characteristic curve (AUC) and calibration plots. We repeated the process on second pandemic wave (October-December 2020) data. RESULTS We identified 55,425 patients with an incident solid cancer. We selected 21 comorbidities as independent predictors. The first four score classes showed similar probability of experiencing the outcome (0.2% to 0.5%), while the last showed a probability equal to 5.8%. The score performed well in both the first and second pandemic waves: AUC 0.85 and 0.82, respectively. Our results were robust for major cancer sites too (i.e., colorectal, lung, female breast, and prostate). CONCLUSIONS We developed a high performance comorbidity score for cancer patients and COVID-19. Being based on administrative databases, this score will be useful for adjusting for comorbidity confounding in epidemiological studies on COVID-19 and cancer impact.
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Affiliation(s)
- Paolo Lasalvia
- Evaluative Epidemiology Unit, Department of Epidemiology and Data ScienceFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Annalisa Trama
- Evaluative Epidemiology Unit, Department of Epidemiology and Data ScienceFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Laura Botta
- Evaluative Epidemiology Unit, Department of Epidemiology and Data ScienceFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Matteo Franchi
- National Centre for Healthcare Research and PharmacoepidemiologyUniversity of Milano‐BicoccaMilanItaly,Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative MethodsUniversity of Milano‐BicoccaMilanItaly
| | - Alice Bernasconi
- Evaluative Epidemiology Unit, Department of Epidemiology and Data ScienceFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
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23
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Huang A, Lu Y, Ji J, Yao Y, Guan S, Chen Z, Yu L. The effect of COVID-19 vaccination on epileptic seizures in patients with epilepsy: A clinical observation in China. Hum Vaccin Immunother 2022; 18:2141519. [PMID: 36412219 PMCID: PMC9746452 DOI: 10.1080/21645515.2022.2141519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This observational retrospective study was conducted on patients with epilepsy (PWE) in China who had at least one dose of COVID-19 vaccine and it investigated the safety of vaccination by analyzing changes in epileptic seizures and their influencing factors. Consecutive PWE who were followed up in the epilepsy clinic between June 2021 and May 2022 were enrolled. Data on vaccine type, demographic information, clinical characteristics of epilepsy, and treatment were collected through a questionnaire survey and retrospectively analyzed. PWE were divided into a stable seizure group and a worsening seizure group based on seizure episodes at least 90 days after the first vaccine dose. A total of 79 PWE were included. After vaccination, 14 patients (17.7%) had worsening seizures, 92.9% of whom had an increased seizure frequency. Compared with patients in the stable seizure group, patients in the worsening seizure group had significant differences in baseline monthly seizure frequency (P = .012), improper antiseizure medication (ASM) administration (P = .003) and a disrupted sleep routine (P = .016). Multivariate logistic regression analysis showed that improper ASM administration (OR 6.186, 95% confidence interval [CI] 1.312-29.170; p = .021) and a disrupted sleep routine (OR 6.326, 95% CI 1.326-30.174; p = .021) were significantly associated with seizure worsening. In short, COVID-19 vaccination is safe for PWE, and only those with poor seizure control have the possibility of seizure exacerbation after COVID-19 vaccination. The vaccination per se does not represent a major influencing factor, but the improper use of ASMs and a disrupted sleep routine may be correlated with seizure aggravation after vaccination.
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Affiliation(s)
- Aizhen Huang
- Department of Neurology, Liuzhou Municipal Liutie Central Hospital, Liuzhou, GX, China
| | - Yanting Lu
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, GX, China
| | - Jingjing Ji
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, GX, China
| | - Yankun Yao
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, GX, China
| | - Shiping Guan
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, GX, China
| | - Zirong Chen
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, GX, China
| | - Lu Yu
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, GX, China
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24
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Farrar DS, Drouin O, Moore Hepburn C, Baerg K, Chan K, Cyr C, Donner EJ, Embree JE, Farrell C, Forgie S, Giroux R, Kang KT, King M, Laffin Thibodeau M, Orkin J, Ouldali N, Papenburg J, Pound CM, Price VE, Proulx-Gauthier JP, Purewal R, Ricci C, Sadarangani M, Salvadori MI, Thibeault R, Top KA, Viel-Thériault I, Kakkar F, Morris SK. Risk factors for severe COVID-19 in hospitalized children in Canada: A national prospective study from March 2020–May 2021. THE LANCET REGIONAL HEALTH - AMERICAS 2022; 15:100337. [PMID: 35936225 PMCID: PMC9342862 DOI: 10.1016/j.lana.2022.100337] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Wang G, Bai L, Zhao M, Wang S. Global landscape of COVID-19 and epilepsy research: A bibliometric analysis. Front Neurol 2022; 13:1034070. [PMID: 36353128 PMCID: PMC9637663 DOI: 10.3389/fneur.2022.1034070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/10/2022] [Indexed: 01/03/2023] Open
Abstract
Background A large number of papers regarding coronavirus disease 2019 (COVID-19) and epilepsy have been published since the declaration of the COVID-19 pandemic. However, there is no bibliometric analysis on these papers. In this study, we aimed to analyze the bibliometric characteristics of these papers, thus identifying the trends and future directions of COVID-19 and epilepsy research. Methods Scientific papers regarding COVID-19 and epilepsy were retrieved through searches of the Web of Science Core Collection database. Title, authors, contributing institute, country, source journal, times cited, and additional information were extracted from each selected paper. Microsoft Excel 2019 and GraphPad Prism 8 were used to analyze the extracted data and export the bar charts and tables whilst VOSviewer software was used to perform and visualize co-authorship analysis and co-occurrence analysis of keywords. Results A total of 317 papers regarding COVID-19 and epilepsy were included in the final analysis. Epilepsy & Behavior published the largest number of papers (n = 84). J. Helen Cross and Naoto Kuroda were the most prolific authors (n = 13 each). The United States (n = 88) and the University of London (n = 23) were the country and organization with the most contributions, respectively. The strongest authors' collaborations were between Giovanni Assenza and Jacopo Lanzone and between J. Helen Cross and Nathalie Jette. Selected author keywords were organized into seven clusters, and the keywords in clusters 1 and cluster 4 had the largest average appearing year of any clusters. Conclusion This is the first bibliometric analysis of papers regarding COVID-19 and epilepsy. Our results showed that the United States was the leading country whilst J. Helen Cross was the most influential scholar in COVID-19 and epilepsy research. psychological consequences of COVID-19, and the safety of COVID-19 vaccines for people with epilepsy, are possible areas for future research on COVID-19 and epilepsy.
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Affiliation(s)
- Guangxin Wang
- Shandong Innovation Center of Intelligent Diagnosis, Jinan Central Hospital, Shandong University, Jinan, China
- Department of Pediatics, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Lian Bai
- General Medical Department, Jinan Central Hospital, Shandong University, Jinan, China
| | - Mingxue Zhao
- Shandong Innovation Center of Intelligent Diagnosis, Jinan Central Hospital, Shandong University, Jinan, China
- Department of Pediatics, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Shumei Wang
- General Medical Department, Jinan Central Hospital, Shandong University, Jinan, China
- *Correspondence: Shumei Wang
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26
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Long-term analysis of the effects of COVID-19 in people with epilepsy: Results from a multicenter on-line survey across the pandemic waves. Epilepsy Behav 2022; 135:108900. [PMID: 36115083 PMCID: PMC9404228 DOI: 10.1016/j.yebeh.2022.108900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/12/2022] [Accepted: 08/22/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE The worldwide pandemic caused by SARS-CoV-2 virus posed many challenges to the scientific and medical communities, including the protection and management of fragile populations. People with epilepsy (PWE) are a heterogenous group of subjects, with different treatment regimens and severity of symptoms. During the National lockdown, in Italy many patients with chronic conditions lost their regular follow-up program. The aim of this study was to investigate the impact of COVID-19 on their health status, from the start of the pandemic (March 2020) to July 2021 and one year later. METHODS We proposed an online questionnaire to subjects followed up at different epilepsy centers located in Milano, Monza & Lodi, three of Lombardy, Northern Italy, the most affected areas by the pandemic. Survey evaluated age, sex, characteristics of patients, type of epilepsy and therapies, COVID-19 diagnosis, vaccines, sleep quality, and anxiety status. RESULTS Among 178 analyzed surveys, 37 individuals reported symptoms of COVID-19 in closed contacts, including 9 with molecular diagnosis and 16 PWE performing the nasopharyngeal swab with 3 positive cases. One year later, 35 individuals reported at least one symptom overlapping with those typical of COVID-19, 8 received COVID-19 diagnosis, among which 6 were positive for SARS-CoV-2 infection. According to the sleep quality scale assessment, most PWE (52.3%) had poor sleep quality. Assessing anxiety status, 32 (38.1%) had a pathological score. CONCLUSION In this multicenter study, we observed that PWE do not appear to be at a higher risk of severe COVID-19. It will be fundamental monitoring this group to assess possible differences in long-COVID-19 and/or neuro-COVID-19 prevalence. On the other hand, our survey confirmed the impact of the pandemic on anxiety and quality of sleep in PWE. Thus, it is important to promptly recognize and treat psychological distress in PWE, because it could be a risk factor in seizure aggravation and quality-of-life deterioration. Telemedicine appears to be a useful tool to support patients with chronic diseases, such as epilepsy.
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27
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Kaur A, Singh N, Singh K, Sidhu SK, Kaur H, Jain P, Kaur M, Jairath M. SARS-CoV-2 IgG Antibody Seroprevalence in Children from the Amritsar District of Punjab. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2022. [DOI: 10.15324/kjcls.2022.54.3.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Amandeep Kaur
- The Viral Research and Diagnostic Laboratory, Government Medical College, Amritsar, India
| | - Narinder Singh
- Department of Pediatrics, Government Medical College, Amritsar, India
| | - Kanwardeep Singh
- Department of Microbiology, Government Medical College, Amritsar, India
| | | | - Harleen Kaur
- The Viral Research and Diagnostic Laboratory, Government Medical College, Amritsar, India
| | - Poonam Jain
- The Viral Research and Diagnostic Laboratory, Government Medical College, Amritsar, India
| | - Manmeet Kaur
- Department of Pediatrics, Government Medical College, Amritsar, India
| | - Mohan Jairath
- The Viral Research and Diagnostic Laboratory, Government Medical College, Amritsar, India
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Körbel K, Rosenow F, Maltseva M, Müller H, Schulz J, Tsalouchidou PE, Langenbruch L, Kovac S, Menzler K, Hamacher M, von Podewils F, Willems LM, Mann C, Strzelczyk A. Impact of COVID-19 pandemic on physical and mental health status and care of adults with epilepsy in Germany. Neurol Res Pract 2022; 4:44. [PMID: 36131301 PMCID: PMC9492304 DOI: 10.1186/s42466-022-00209-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/29/2022] [Indexed: 11/23/2022] Open
Abstract
Background To mitigate the potential consequences of the coronavirus disease 2019 (COVID-19) pandemic on public life, the German Federal Government and Ministry of Health enacted a strict lockdown protocol on March 16, 2020. This study aimed to evaluate the impact of the COVID-19 pandemic on physical and mental health status and the supply of medical care and medications for people with epilepsy (PWE) in Germany. Methods The Epi2020 study was a large, multicenter study focused on different healthcare aspects of adults with epilepsy. In addition to clinical and demographic characteristics, patients were asked to answer a questionnaire on the impact of the first wave of the COVID-19 pandemic between March and May 2020. Furthermore, the population-based number of epilepsy-related admissions in Hessen was evaluated for the January-June periods of 2017–2020 to detect pandemic-related changes. Results During the first wave of the pandemic, 41.6% of PWE reported a negative impact on their mental health, while only a minority reported worsening of their seizure situation. Mental and physical health were significantly more negatively affected in women than men with epilepsy and in PWE without regular employment. Moreover, difficulties in ensuring the supply of sanitary products (25.8%) and antiseizure medications (ASMs; 19.9%) affected PWE during the first lockdown; no significant difference regarding these impacts between men and women or between people with and without employment was observed. The number of epilepsy-related admissions decreased significantly during the first wave. Conclusions This analysis provides an overview of the general and medical care of epilepsy patients during the COVID-19 pandemic. PWE in our cohort frequently reported psychosocial distress during the first wave of the pandemic, with significant adverse effects on mental and physical health. Women and people without permanent jobs especially reported distress due to the pandemic. The COVID‐19 pandemic has added to the mental health burden and barriers to accessing medication and medical services, as self-reported by patients and verified in population-based data on hospital admissions. Trial registration German Clinical Trials Register (DRKS), DRKS00022024. Registered October 2, 2020, http://www.drks.de/DRKS00022024
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Hussaini H, Rogers S, Kataria S, Uddin K, Mohamed KH, Mohamed AS, Tariq F, Ahmad S, Awais A, Ahmed Z, Chukwurah A, Khan A. COVID-19-Induced Seizures: A Meta-Analysis of Case Series and Retrospective Cohorts. Cureus 2022; 14:e28633. [PMID: 36196331 PMCID: PMC9524720 DOI: 10.7759/cureus.28633] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 11/30/2022] Open
Abstract
The adverse events and complications of coronavirus disease 2019 (COVID-19) continue to challenge the medical profession despite the worldwide vaccination against the severe acute respiratory coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19. Other than typical respiratory manifestations, COVID-19 also presents a wide range of neurological manifestations. This article underlines the pooled incidence of COVID-19-induced seizures in patients with epilepsy and without epilepsy. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocols, we conducted a bibliographical search, and an initial search revealed 1,375 articles. In total, 21 articles were included in the final analysis by following the inclusion criteria. A total of 11,526 patients from 21 published articles that met the predetermined search criteria were included. The median age of the patients was 61.9 years, of whom 51.5% were males. A total of 255 patients presented with seizures as the first manifestation of COVID-19 with a prevalence of 2.2% (95% confidence interval = 0.05-0.24, p < 0.01) (I2 = 97%), of which 71 patients had previously been diagnosed with epilepsy. Among patients with epilepsy, 49 patients had seizures as an initial presentation of SARA-CoV-2 with an incidence of 72% (0.54-0.85, p = 0.1) (I2 = 34). Although the incidence of COVID-19-induced seizures is not high compared to other neurological manifestations, seizure incidence in epileptic patients with COVID-19 is remarkably high. New-onset seizures in any patient should be considered a presentation of COVID-19 in the absence of other causative factors.
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Chan CCH, Choi C, Lui WT, Ip B, Ma K, Ma SH, Fan FSY, Au L, Lau A, Chan A, Ip V, Soo Y, Leung T, Mok V, Leung H. A cross-sectional study of COVID-19 vaccination patterns among patients with epilepsy in Hong Kong. Epilepsia Open 2022; 7:570-577. [PMID: 35867810 PMCID: PMC9349844 DOI: 10.1002/epi4.12629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 06/19/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE As Hong Kong faced the 5th wave of the COVID-19 pandemic, the facilitators and hurdles toward effective vaccination is important for healthcare professionals to understand the vaccination gap among patients with epilepsy. METHODS A cross-sectional, pragmatic study of COVID-19 vaccination was performed at a tertiary epilepsy center with regards to patterns of vaccination and any unusually high rate of adverse events. Patients having recent visits at the epilepsy center (4 months) had their anonymized electronic linkage records examined 12 months after the inception of vaccination program for types of vaccines, seizure demographics, and adverse events following immunization (AEFI). RESULTS A total of 200 patients with epilepsy and their anonymized data were analyzed. The vaccine uptake was approximately 60% of that of the general population. Twice as many patients with epilepsy chose to receive mRNA vaccine as compared with inactivated vaccine. The proportion of patients who kept up-to-date with all available dosing was 7%. Patients with epilepsy with genetic etiology were least likely to receive vaccination (13/38, 34%, P = .02). There was no unreasonably high rate of unacceptable side effects after vaccination among patients with epilepsy. Only 3 patients reported worsening of seizures without meeting the criteria for AEFI. Refractory epilepsy, allergy to antiseizure medications and elder age (≥65) did not confer any significant difference in vaccination patterns or adverse effects. SIGNIFICANCE A vaccination gap exists among epilepsy patients which calls for actionable strategies for improving vaccine uptake, including education and outreach programs.
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Affiliation(s)
- Charlie CH Chan
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Chun‐Ho Choi
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Wai Ting Lui
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Bonaventure Ip
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Karen KY Ma
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Sze Ho Ma
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Florence SY Fan
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Lisa Au
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Alexander Lau
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Anne YY Chan
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Vincent Ip
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Yannie Soo
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Thomas Leung
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Vincent Mok
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Howan Leung
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina,Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
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Muccioli L, Zenesini C, Taruffi L, Licchetta L, Mostacci B, Di Vito L, Pasini E, Volpi L, Riguzzi P, Ferri L, Baccari F, Nonino F, Michelucci R, Tinuper P, Vignatelli L, Bisulli F. Risk of hospitalization and death for COVID-19 in persons with epilepsy over a 20-month period: the EpiLink Bologna cohort, Italy. Epilepsia 2022; 63:2279-2289. [PMID: 35778963 PMCID: PMC9349826 DOI: 10.1111/epi.17356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/30/2022] [Accepted: 06/30/2022] [Indexed: 11/28/2022]
Abstract
Objective Data on COVID‐19 outcomes in persons with epilepsy (PWE) are scarce and inconclusive. We aimed to study the risk of hospitalization and death for COVID‐19 in a large cohort of PWE from March 1, 2020 to October 31, 2021. Methods The historical cohort design (EpiLink Bologna) compared adult PWE grouped into people with focal epilepsy (PFE), idiopathic generalized epilepsy (PIGE), and developmental and/or epileptic encephalopathy (PDEE), and a population cohort matched (ratio 1:10) for age, sex, residence, and comorbidity (assessed with the multisource comorbidity score), living in the local health trust of Bologna (approximately 800 000 residents). Clinical data were linked to health administrative data. Results In both cohorts (EpiLink: n = 1575 subjects, 1128 PFE, 267 PIGE, 148 PDEE, 32 other; controls: n = 15 326 subjects), 52% were females, and the mean age was 50 years (SD = 18). Hospital admissions for COVID‐19 in the whole period were 49 (3.1%) in PWE and 225 (1.5%) in controls. The adjusted hazard ratio (aHR) in PWE was 1.9 (95% confidence interval [CI] = 1.4–2.7). The subgroups at higher risk were PFE (aHR = 1.9, 95% CI = 1.3–2.8) and PDEE (aHR = 3.9, 95% CI = 1.7–8.7), whereas PIGE had a risk comparable to the controls (aHR = 1.1, 95% CI = .3–3.5). Stratified analyses of the two main epidemic waves (March–May 2020, October 2020–May 2021) disclosed a higher risk of COVID‐19‐related hospitalization during the first epidemic wave (March–May 2020; aHR = 3.8, 95% CI = 2.2–6.7). Polytherapy with antiseizure medications contributed to a higher risk of hospital admission. Thirty‐day risk of death after hospitalization was 14% in both PWE and controls. Significance During the first 20 months since the outbreak of COVID‐19 in Bologna, PWE had a doubled risk of COVID‐19 hospital admission compared to a matched control population. Conversely, epilepsy did not represent a risk factor for COVID‐19‐related death.
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Affiliation(s)
- Lorenzo Muccioli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Corrado Zenesini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Lisa Taruffi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Laura Licchetta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Barbara Mostacci
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Lidia Di Vito
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Elena Pasini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Lilia Volpi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Patrizia Riguzzi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Lorenzo Ferri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Flavia Baccari
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Francesco Nonino
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Paolo Tinuper
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Luca Vignatelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Francesca Bisulli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
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Degarege A, Naveed Z, Kabayundo J, Brett-Major D. Heterogeneity and Risk of Bias in Studies Examining Risk Factors for Severe Illness and Death in COVID-19: A Systematic Review and Meta-Analysis. Pathogens 2022; 11:563. [PMID: 35631084 PMCID: PMC9147100 DOI: 10.3390/pathogens11050563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 02/07/2023] Open
Abstract
This systematic review and meta-analysis synthesized the evidence on the impacts of demographics and comorbidities on the clinical outcomes of COVID-19, as well as the sources of the heterogeneity and publication bias of the relevant studies. Two authors independently searched the literature from PubMed, Embase, Cochrane library, and CINAHL on 18 May 2021; removed duplicates; screened the titles, abstracts, and full texts by using criteria; and extracted data from the eligible articles. The variations among the studies were examined by using Cochrane, Q.; I2, and meta-regression. Out of 11,975 articles that were obtained from the databases and screened, 559 studies were abstracted, and then, where appropriate, were analyzed by meta-analysis (n = 542). COVID-19-related severe illness, admission to the ICU, and death were significantly correlated with comorbidities, male sex, and an age older than 60 or 65 years, although high heterogeneity was present in the pooled estimates. The study design, the study country, the sample size, and the year of publication contributed to this. There was publication bias among the studies that compared the odds of COVID-19-related deaths, severe illness, and admission to the ICU on the basis of the comorbidity status. While an older age and chronic diseases were shown to increase the risk of developing severe illness, admission to the ICU, and death among the COVID-19 patients in our analysis, a marked heterogeneity was present when linking the specific risks with the outcomes.
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Affiliation(s)
- Abraham Degarege
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA; (Z.N.); (J.K.); (D.B.-M.)
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Mena-Vázquez N, García-Studer A, Rojas-Gimenez M, Romero-Barco CM, Manrique-Arija S, Mucientes A, Velloso-Feijoo ML, Godoy-Navarrete FJ, Morales-Garrido P, Redondo-Rodríguez R, Ordoñez-Cañizares MC, Ortega-Castro R, Lisbona-Montañez JM, Hidalgo Conde A, Arnedo Díez de los Ríos R, Cabrera César E, Espildora F, Aguilar-Hurtado MC, Añón-Oñate I, Ureña-Garnica I, Fernández-Nebro A. Importance of Vaccination against SARS-CoV-2 in Patients with Interstitial Lung Disease Associated with Systemic Autoimmune Disease. J Clin Med 2022; 11:jcm11092437. [PMID: 35566564 PMCID: PMC9106041 DOI: 10.3390/jcm11092437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/23/2022] [Accepted: 04/24/2022] [Indexed: 01/09/2023] Open
Abstract
Objectives: To describe the frequency of COVID-19 and the effect of vaccination in patients with interstitial lung disease and systemic autoimmune disease (ILD-SAD) and to identify factors associated with infection and severity of COVID-19. Methods: We performed a cross-sectional multicenter study of patients with ILD-SAD followed between June and October 2021. The main variable was COVID-19 infection confirmed by a positive polymerase chain reaction (PCR) result for SARS-CoV-2. The secondary variables included severity of COVID-19, if the patient had to be admitted to hospital or died of the disease, and vaccination status. Other variables included clinical and treatment characteristics, pulmonary function and high-resolution computed tomography. Two logistic regression was performed to explore factors associated with “COVID-19” and “severe COVID-19”. Results: We included 176 patients with ILD-SAD: 105 (59.7%) had rheumatoid arthritis, 49 (27.8%) systemic sclerosis, and 22 (12.54%) inflammatory myopathies. We recorded 22/179 (12.5%) SARS-CoV-2 infections, 7/22 (31.8%) of them were severe and 3/22 (13.22%) died. As to the vaccination, 163/176 (92.6%) patients received the complete doses. The factors associated with SARS-CoV-2 infection were FVC (OR (95% CI), 0.971 (0.946−0.989); p = 0.040), vaccination (OR (95% CI), 0.169 (0.030−0.570); p = 0.004), and rituximab (OR (95% CI), 3.490 (1.129−6.100); p = 0.029). The factors associated with severe COVID-19 were the protective effect of the vaccine (OR (95% CI), 0.024 (0.004−0.170); p < 0.001) and diabetes mellitus (OR (95% CI), 4.923 (1.508−19.097); p = 0.018). Conclusions: Around 13% of patients with ILD-SAD had SARS-CoV-2 infection, which was severe in approximately one-third. Most patients with severe infection were not fully vaccinated.
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Affiliation(s)
- Natalia Mena-Vázquez
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Cordoba, Spain; (M.R.-G.); (R.O.-C.)
- Correspondence:
| | - Aimara García-Studer
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
| | - Marta Rojas-Gimenez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Cordoba, Spain; (M.R.-G.); (R.O.-C.)
- UGC de Reumatología, Hospital Universitario Reina Sofía de Córdoba, 14004 Cordoba, Spain
| | - Carmen María Romero-Barco
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Clínico Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Sara Manrique-Arija
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
- Departamento de Medicina, Universidad de Málaga, 29016 Malaga, Spain
| | - Arkaitz Mucientes
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
| | | | | | | | - Rocío Redondo-Rodríguez
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
| | - MC Ordoñez-Cañizares
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Clínico Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Rafaela Ortega-Castro
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Cordoba, Spain; (M.R.-G.); (R.O.-C.)
- UGC de Reumatología, Hospital Universitario Reina Sofía de Córdoba, 14004 Cordoba, Spain
| | - Jose Manuel Lisbona-Montañez
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
- Departamento de Medicina, Universidad de Málaga, 29016 Malaga, Spain
| | - Ana Hidalgo Conde
- Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain; (A.H.C.); (R.A.D.d.l.R.)
| | - Rocío Arnedo Díez de los Ríos
- Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain; (A.H.C.); (R.A.D.d.l.R.)
| | - Eva Cabrera César
- UGC Neumología, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain;
| | - Francisco Espildora
- UGC de Neumología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
| | | | - Isabel Añón-Oñate
- Hospital Universitario de Jaén, 23007 Jaén, Spain; (F.J.G.-N.); (I.A.-O.)
| | - Inmaculada Ureña-Garnica
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
| | - Antonio Fernández-Nebro
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
- Departamento de Medicina, Universidad de Málaga, 29016 Malaga, Spain
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Yoo J, Kim JH, Jeon J, Kim J, Song TJ. Risk of COVID-19 Infection and of Severe Complications Among People With Epilepsy: A Nationwide Cohort Study. Neurology 2022; 98:e1886-e1892. [PMID: 35338078 DOI: 10.1212/wnl.0000000000200195] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 01/27/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate whether patients with epilepsy were more susceptible to coronavirus disease 2019 (COVID-19) infection and at greater risk of severe complications when infected with COVID-19 when compared with patients without epilepsy. METHODS We included participants who underwent at least one SARS-CoV-2 real-time reverse transcription polymerase chain reaction test between Jan 1 and June 4, 2020 from the Korean nationwide COVID-19 dataset. Epilepsy was defined according to the presence of diagnostic code in health claims data prior to the COVID-19 diagnosis. To investigate the association between epilepsy and the susceptibility or severe complications of COVID-19, a 1:6 ratio propensity score matching (PSM) and logistic regression analysis were performed. Severe complications with COVID-19 infection were defined as a composite of the incidence of mechanical ventilation, intensive care unit admission, and death within two months after COVID-19 diagnosis. RESULTS Among 212,678 study participants who underwent COVID-19 test, 3,919 (1.8%) had a history of epilepsy. After PSM, there was no significant difference in COVID-19 PCR positivity according to epilepsy history [odds ratio (OR): 0.86, 95% confidence interval (CI) 0.67-1.11]. Of the 7,713 individuals with confirmed COVID-19 infection, 72 (0.9%) had a history of epilepsy. Among the COVID-19 patients, the severe complications occurred in 444 (5.8%) individuals. After PSM, the presence of epilepsy was associated with occurrence of severe complications after COVID-19 infection [OR: 2.05, 95% CI: 1.04-4.04]. Mortality following COVID-19 infection did not differ according to the presence of epilepsy history [OR: 1.55, 95% CI: 0.65-3.70]. CONCLUSIONS The presence of epilepsy was not associated with increased susceptibility to COVID-19 infection or mortality related to the infection. However, there was an increased risk of severe complications with COVID-19 in patients with epilepsy; therefore, careful management and monitoring may be necessary.
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Affiliation(s)
- Joonsang Yoo
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Republic of Korea
| | - Jee Hyun Kim
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Jimin Jeon
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Republic of Korea
| | - Jinkwon Kim
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
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Park E, You J. A Case Report for Using Methylprednisolone for Severe ARDS Caused by SARS-CoV-2 Delta Variant in a Pediatric Patient With Lennox-Gastaut Syndrome. J Korean Med Sci 2022; 37:e82. [PMID: 35289141 PMCID: PMC8921209 DOI: 10.3346/jkms.2022.37.e82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/14/2022] [Indexed: 01/08/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in the coronavirus disease 2019 (COVID-19) pandemic. COVID-19 can result in fatal comorbidities, including acute respiratory distress syndrome (ARDS). Several reports suggest that children have milder illness, though severe cases have still been reported. We report a 9-year-old boy with ARDS caused by the SARS-CoV-2 delta (B.1.617.2) variant. He was admitted to our hospital and carefully observed due to underlying Lennox-Gastaut syndrome. He developed intractable seizures with a high fever. Although the seizures were controlled, his respiratory condition deteriorated to severe ARDS. High-dose methylprednisolone was administered with high positive end-expiratory pressure and low tidal volume. After ARDS treatment, oxygenation improved sufficiently to permit extubation. This case suggests that close observation is required in pediatric patients with neurologic comorbidities because of an increased risk for severe COVID-19.
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Affiliation(s)
- Esther Park
- Department of Pediatrics, Jeonbuk National University Children's Hospital, Jeonju, Korea
| | - Jihye You
- Department of Pediatrics, Jeonbuk National University Children's Hospital, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Korea.
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Fine AL, Wong-Kisiel LC, Nickels KC, Wirrell EC. Masking for School-Age Children With Epilepsy: We Do Have Consensus! J Child Neurol 2022; 37:127-132. [PMID: 34986033 DOI: 10.1177/08830738211063684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION This study was designed to assess current recommendations from child neurologists and epileptologists on masking for school-age children with epilepsy. METHODS A 7-item survey was created and sent out to members of the Child Neurology Society and Pediatric Epilepsy Research Consortium in August of 2021 to assess current practice and provider recommendations on masking. RESULTS One hundred four individuals participated with representation from all regions of the United States. Masking was recommended by 95.1%, with 63.4% (n = 66) noting exception of those with severe intellectual disability, autism, and behavioral problems. Of those who write exemption letters, 54% write these <5% of the time. Only 3% reported potential adverse events associated with masking. CONCLUSION Nearly all respondents recommended masking for school-age children with epilepsy. Potential risks of masking and adverse events were low. Improved guidance on masking is needed to ensure academic success of our patients with epilepsy.
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Romozzi M, Rollo E, Quintieri P, Dono F, Evangelista G, Consoli S, Veleno L, Anzellotti F, Calvello C, Costa C, Servidei S, Calabresi P, Vollono C. Impact of COVID-19 vaccine on epilepsy in adult subjects: an Italian multicentric experience. Neurol Sci 2022; 43:4627-4634. [PMID: 35501537 PMCID: PMC9059692 DOI: 10.1007/s10072-022-06100-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/25/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To investigate the safety and tolerability of COVID-19 vaccines in people with epilepsy (PwE). METHODS In this multicentric observational cohort study, we recruited adult patients (age > 18 years old) with epilepsy who attended the Outpatient Epilepsy Clinic from 1st July to 30th October 2021. We administered to the patients a structured questionnaire and interview on demographic and epilepsy characteristics, current treatment, previous SARS-CoV-2 infection, vaccine characteristics, post-vaccine seizure relapse, other side effect, variation of sleep habits, caffeine, or alcohol intake. Seizure frequency worsening was defined as a ratio between mean monthly frequency post-vaccination and mean monthly frequency pre-vaccination superior to 1. Patients were categorized in two groups: patients with seizure frequency worsening (WORSE) and patients with seizure stability (STABLE). RESULTS A total of 358 people participated with a mean age of 47.46 ± 19.04. Focal seizure (79.1%), generalized epilepsy (20.4%), and unknown types of epilepsy (0.5%) were detected among participants. In total, 31 (8.7%) people expressed that they were not willing to receive a COVID-19 vaccine; 302 patients (92.35%) did not experience an increase in the seizure frequency (STABLE-group) whereas 25 patients (7.65%) had a seizure worsening (WORSE-group). Post-vaccine seizures occurred mainly in the 7 days following the administration of the vaccine. Patients in the WORSE-group were treated with a mean higher number of anti-seizure medication (ASMs) (p = 0.003) and had a higher pre-vaccine seizure frequency (p = 0.009) compared with patients in the STABLE-group. Drug-resistant epilepsy was also associated with seizure worsening (p = 0.01). One-year pre-vaccination seizure frequency pattern demonstrated that patients in the WORSE-group had a higher frequency pattern (p < 0.001). Multivariate analysis of the vaccinated group showed that only the seizure frequency pattern (confidence interval [CI] = 1.257-2.028; p < 0.001) was significantly associated with seizure worsening. CONCLUSION In our cohort of vaccinated PwE, only a little percentage had a transient short-term increase of seizure frequency. The present study demonstrates that COVID-19 vaccines have a good safety and tolerability profile in the short term in PwE.
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Affiliation(s)
- Marina Romozzi
- Dipartimento Universitario Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurologia, Dipartimento Di Scienze Dell'invecchiamento, Neurologiche, Ortopediche E Della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Eleonora Rollo
- Dipartimento Universitario Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurologia, Dipartimento Di Scienze Dell'invecchiamento, Neurologiche, Ortopediche E Della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Paolo Quintieri
- Dipartimento Universitario Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fedele Dono
- Dipartimento Di Neuroscienze, Imaging E Scienze Cliniche, "G. D'Annunzio, Università Di Chieti-Pescara, Chieti, Italy.
- Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.
| | - Giacomo Evangelista
- Dipartimento Di Neuroscienze, Imaging E Scienze Cliniche, "G. D'Annunzio, Università Di Chieti-Pescara, Chieti, Italy
| | - Stefano Consoli
- Dipartimento Di Neuroscienze, Imaging E Scienze Cliniche, "G. D'Annunzio, Università Di Chieti-Pescara, Chieti, Italy
| | - Luigi Veleno
- Dipartimento Di Neuroscienze, Imaging E Scienze Cliniche, "G. D'Annunzio, Università Di Chieti-Pescara, Chieti, Italy
| | - Francesca Anzellotti
- Dipartimento Di Neuroscienze, Imaging E Scienze Cliniche, "G. D'Annunzio, Università Di Chieti-Pescara, Chieti, Italy
| | - Carmen Calvello
- Sezione Di Neurologia, Dipartimento Di Medicina E Chirurgia, Università Di Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy
| | - Cinzia Costa
- Sezione Di Neurologia, Dipartimento Di Medicina E Chirurgia, Università Di Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy
| | - Serenella Servidei
- Dipartimento Universitario Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurofisiopatologia, Dipartimento Di Scienze Dell'invecchiamento, Neurologiche, Ortopediche E Della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Paolo Calabresi
- Dipartimento Universitario Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurologia, Dipartimento Di Scienze Dell'invecchiamento, Neurologiche, Ortopediche E Della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Catello Vollono
- Dipartimento Universitario Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurofisiopatologia, Dipartimento Di Scienze Dell'invecchiamento, Neurologiche, Ortopediche E Della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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Horváth RA, Sütő Z, Cséke B, Schranz D, Darnai G, Kovács N, Janszky I, Janszky J. Epilepsy is overrepresented among young people who died from COVID-19: Analysis of nationwide mortality data in Hungary. Seizure 2022; 94:136-141. [PMID: 34906799 PMCID: PMC8634695 DOI: 10.1016/j.seizure.2021.11.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/27/2021] [Accepted: 11/17/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Studies examining epilepsy as a COVID-related death risk have come to conflicting conclusions. Our aim was to assess the prevalence of epilepsy among COVID-related deaths in Hungary. METHODS Each COVID-19 infection case is required to be reported on a daily basis to the National Public Health Center of Hungary. This online report includes the beginning and end of the infection, as well as information on comorbidities. Death during infection is regarded as COVID-related. The anonymized data of each deceased patient are published on an information website (www.koronavirus.gov.hu) and provides up-to-date information on each patient with the date of death, the patient's sex, age, and chronic illness. RESULTS There were 11,968 patients who died of COVID-19 in Hungary between 13 March 2020 and 23 January 2021. Among 11,686 patients with no missing values for comorbidities, 255 patients had epilepsy (2.2%). Epilepsy was much more common among those who died at a young age: 9.3% of those who died under the age of 50 had epilepsy, compared with only 1.3% in those over the age of 80. The younger an age group was, the higher was the prevalence of epilepsy. CONCLUSION Patients who died of COVID-19 under the age of 50 were 10 to 20 times more likely to have epilepsy than what would have been expected from epidemiological data. Our results highlight the need for increased protection of young people with epilepsy from COVID-19 infection and the development of a vaccination strategy accordingly.
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Affiliation(s)
- Réka A. Horváth
- Department of Neurology, Medical School, University of Pécs, Rét u. 2, H-7623 Pécs, Hungary
| | - Zsófia Sütő
- Department of Neurology, Medical School, University of Pécs, Rét u. 2, H-7623 Pécs, Hungary
| | - Balázs Cséke
- Department of Neurology, Medical School, University of Pécs, Rét u. 2, H-7623 Pécs, Hungary
| | - Dániel Schranz
- Department of Neurology, Medical School, University of Pécs, Rét u. 2, H-7623 Pécs, Hungary
| | - Gergely Darnai
- Department of Neurology, Medical School, University of Pécs, Rét u. 2, H-7623 Pécs, Hungary,MTA-PTE Clinical Neuroscience MRI Research Group. Hungary, Ifjúság u. 20., H-7624 Pécs, Hungary,Department of Behavioral Sciences, Medical School, University of Pécs, Rét u. 2, H-7623 Pécs, Hungary
| | - Norbert Kovács
- Department of Neurology, Medical School, University of Pécs, Rét u. 2, H-7623 Pécs, Hungary,MTA-PTE Clinical Neuroscience MRI Research Group. Hungary, Ifjúság u. 20., H-7624 Pécs, Hungary
| | - Imre Janszky
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Håkon Jarls gate 11 and Mauritz Hanssens gate, 7491 Trondheim, Norway,Regional Center for Health Care Improvement, St Olav's Hospital, Trondheim, Norway
| | - József Janszky
- Department of Neurology, Medical School, University of Pécs, Rét u. 2, H-7623 Pécs, Hungary,MTA-PTE Clinical Neuroscience MRI Research Group. Hungary, Ifjúság u. 20., H-7624 Pécs, Hungary,Corresponding author at: Department of Neurology, Medical School, University of Pécs, Rét u. 2, H-7623 Pécs, Hungary
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COVID-19 prevalence and mortality in people with epilepsy: A nation-wide multicenter study. Epilepsy Behav 2021; 125:108379. [PMID: 34731719 PMCID: PMC9759834 DOI: 10.1016/j.yebeh.2021.108379] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/01/2021] [Accepted: 10/02/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND To assess the prevalence, severity, and mortality of COVID-19 in people with epilepsy (PWE) and evaluate seizure control in PWE during and after COVID-19. METHODS Retrospective, observational, multicenter study conducted in 14 hospitals. Medical records of randomly selected PWE followed at neurology outpatient clinics were reviewed. Proportion of PWE with a positive test for SARS-CoV-2 during 2020 was calculated. Risk factors associated with COVID-19 and its morbimortality were evaluated. RESULTS 2751 PWE were included, mean age 48.8 years (18-99), 72.4% had focal epilepsy, and 35% were drug-refractory. COVID-19 prevalence in PWE was 5.53%, while in the Spanish population was 4.26%. Proportion of admissions to hospital, ICU, and deaths in PWE were 17.1%, 2%, and 4.61% of COVID-19 cases, while in Spanish population were 10.81%, 0.95%, and 2.57%, respectively. A severe form of COVID-19 occurred in 11.8%; dyslipidemia, institutionalization at long-term care facilities, intellectual disability, and older age were associated risk factors. Older age, hypertension, dyslipidemia, cardiac disease, and institutionalization were associated with mortality from COVID-19. Seizure control was stable in 90.1% of PWE during acute COVID-19, while 8.6% reported an increase in seizure frequency. During post-COVID-19 follow-up, 4.6% reported seizure control worsening. CONCLUSIONS COVID-19 was moderately prevalent in PWE. One out of 5 patients required medical attention and 4.6% died due to COVID-19. Older age, dyslipidemia, institutionalization, and intellectual disability were significant risk factors associated with severe COVID-19. Seizure control remained stable during COVID-19 and throughout long-term follow-up in most PWE who contracted the infection.
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Siahaan YMT, Ketaren RJ, Hartoyo V, Hariyanto TI. Epilepsy and the risk of severe coronavirus disease 2019 outcomes: A systematic review, meta-analysis, and meta-regression. Epilepsy Behav 2021; 125:108437. [PMID: 34839246 PMCID: PMC8590948 DOI: 10.1016/j.yebeh.2021.108437] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/19/2021] [Accepted: 11/08/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patients with epilepsy experience seizures, which have been reported to increase and worsen during the coronavirus disease (COVID-19) pandemic. However, the association between epilepsy and COVID-19 outcomes remains unclear. The aim of this study was to analyze whether patients with epilepsy have an increased risk of having poor COVID-19 outcomes. METHODS We comprehensively evaluated potential articles extracted from the medRxiv, Europe PMC, and PubMed databases until June 30, 2021, using selected keywords. All published studies on epilepsy and COVID-19 were selected. We used the Review Manager 5.4 and Comprehensive Meta-Analysis 3 software for statistical analysis. RESULTS Thirteen studies with 67,131 patients with COVID-19 were included in the analysis. Evaluation of the collated data revealed an association between epilepsy and increased severity of COVID-19 (OR, 1.69; 95%CI: 1.11-2.59; p = 0.010; I2 = 29%; random-effect modeling) and mortality from COVID-19 (OR, 1.71; 95%CI: 1.14-2.56; p = 0.010; I2 = 53%; random-effect modeling). The results also showed that the association between epilepsy and increased risk of developing severe COVID-19 is influenced by sex and neurodegenerative disease. CONCLUSIONS The findings of this study suggest that patients with epilepsy are at risk of having poor COVID-19 outcomes. Patients with epilepsy need special attention and should be prioritized for administration of the COVID-19 vaccine. Registration details: PROSPERO (CRD42021264979).
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Affiliation(s)
- Yusak Mangara Tua Siahaan
- Department of Neurology, Faculty of Medicine, Pelita Harapan University, Karawaci, Tangerang 15811, Indonesia
| | - Retno Jayantri Ketaren
- Department of Neurology, Faculty of Medicine, Pelita Harapan University, Karawaci, Tangerang 15811, Indonesia
| | - Vinson Hartoyo
- Department of Neurology, Faculty of Medicine, Pelita Harapan University, Karawaci, Tangerang 15811, Indonesia
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Corrao G, Rea F, Carle F, Scondotto S, Allotta A, Lepore V, D'Ettorre A, Tanzarella C, Vittori P, Abena S, Iommi M, Spazzafumo L, Ercolanoni M, Blaco R, Carbone S, Giordani C, Manfellotto D, Galli M, Mancia G. Stratification of the risk of developing severe or lethal Covid-19 using a new score from a large Italian population: a population-based cohort study. BMJ Open 2021; 11:e053281. [PMID: 34794995 PMCID: PMC8602929 DOI: 10.1136/bmjopen-2021-053281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To develop a population-based risk stratification model (COVID-19 Vulnerability Score) for predicting severe/fatal clinical manifestations of SARS-CoV-2 infection, using the multiple source information provided by the healthcare utilisation databases of the Italian National Health Service. DESIGN Retrospective observational cohort study. SETTING Population-based study using the healthcare utilisation database from five Italian regions. PARTICIPANTS Beneficiaries of the National Health Service, aged 18-79 years, who had the residentship in the five participating regions. Residents in a nursing home were not included. The model was built from the 7 655 502 residents of Lombardy region. MAIN OUTCOME MEASURE The score included gender, age and 29 conditions/diseases selected from a list of 61 conditions which independently predicted the primary outcome, that is, severe (intensive care unit admission) or fatal manifestation of COVID-19 experienced during the first epidemic wave (until June 2020). The score performance was validated by applying the model to several validation sets, that is, Lombardy population (second epidemic wave), and the other four Italian regions (entire 2020) for a total of about 15.4 million individuals and 7031 outcomes. Predictive performance was assessed by discrimination (areas under the receiver operating characteristic curve) and calibration (plot of observed vs predicted outcomes). RESULTS We observed a clear positive trend towards increasing outcome incidence as the score increased. The areas under the receiver operating characteristic curve of the COVID-19 Vulnerability Score ranged from 0.85 to 0.88, which compared favourably with the areas of generic scores such as the Charlson Comorbidity Score (0.60). A remarkable performance of the score on the calibration of observed and predicted outcome probability was also observed. CONCLUSIONS A score based on data used for public health management accurately predicted the occurrence of severe/fatal manifestations of COVID-19. Use of this score may help health decision-makers to more accurately identify high-risk citizens who need early preventive or treatment interventions.
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Affiliation(s)
- Giovanni Corrao
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
| | - Federico Rea
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
| | - Flavia Carle
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Center of Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, Italy
| | - Salvatore Scondotto
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Department of Health Services and Epidemiological Observatory, Regional Health Authority of Sicily, Palermo, Italy
| | - Alessandra Allotta
- Department of Health Services and Epidemiological Observatory, Regional Health Authority of Sicily, Palermo, Italy
| | - Vito Lepore
- Regional Health Agency of Puglia, Bari, Italy
| | | | | | | | | | - Marica Iommi
- Center of Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, Italy
| | - Liana Spazzafumo
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Regional Health Agency of Marche, Ancona, Italy
| | | | | | - Simona Carbone
- Department of Health Planning, Italian Health Ministry, Rome, Italy
| | | | - Dario Manfellotto
- Department of Internal Medicine, Hospital Fatebenefratelli, Rome, Italy
| | - Massimo Galli
- Institute of Tropical and Infectious Diseases, University of Milan L Sacco Hospital, Milan, Italy
| | - Giuseppe Mancia
- University of Milano-Bicocca, Milan, Italy
- Policlinico di Monza, Monza, Italy
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Abstract
Incidence and Case Fatality Rate of COVID-19 in Patients With Active
Epilepsy Cabezudo-Garcia P, Ciano-Petersen NL, Mena-Vazquez N, et al.
Neurology. 2020;95(10):e1417-e1425.
doi:10.1212/WNL.0000000000010033 Objective: This article estimates the incidence and fatality of coronavirus disease 2019
(COVID-19) and identifies potential risk factors for fatality in patients with
active epilepsy. Methods: This 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 to an
emergency department divided by the total number of patients with epilepsy at risk,
and CFR based on the number of deaths during the enrollment period. Multiple
logistic regression analysis was performed to investigate risk factors for fatality
in patients with active epilepsy. Results: Of the 1537 patients who fulfilled the inclusion criteria, 21 (1.3%) had active
epilepsy. The cumulative incidence (95% CI) of COVID-19 in patients with epilepsy
was higher (1.2% [0.6-2.4]) compared to the population without epilepsy (0.5%
[0.5-0.5]). In reverse transcription polymerase chain reaction–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 = .266). Of
the 21 patients with active epilepsy, 5 (23%) died. In multivariate analysis, the
factor associated with fatality in patients with active epilepsy was hypertension
(odds ratio [OR] 2.8 [95% CI: 1.3-21.6]). In another model, age (OR: 1.0 [95% CI:
1.0-1.1]) and epilepsy (OR: 5.1 [95% CI: 1.3-24.0]) were associated with fatality
during hospitalization. Conclusion: COVID-19 cumulative incidence was 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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Liu L, Ni SY, Yan W, Lu QD, Zhao YM, Xu YY, Mei H, Shi L, Yuan K, Han Y, Deng JH, Sun YK, Meng SQ, Jiang ZD, Zeng N, Que JY, Zheng YB, Yang BN, Gong YM, Ravindran AV, Kosten T, Wing YK, Tang XD, Yuan JL, Wu P, Shi J, Bao YP, Lu L. Mental and neurological disorders and risk of COVID-19 susceptibility, illness severity and mortality: A systematic review, meta-analysis and call for action. EClinicalMedicine 2021; 40:101111. [PMID: 34514362 PMCID: PMC8424080 DOI: 10.1016/j.eclinm.2021.101111] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has evolved into a worldwide pandemic, and has been found to be closely associated with mental and neurological disorders. We aimed to comprehensively quantify the association between mental and neurological disorders, both pre-existing and subsequent, and the risk of susceptibility, severity and mortality of COVID-19. METHODS In this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, PsycINFO, and Cochrane library databases for studies published from the inception up to January 16, 2021 and updated at July 7, 2021. Observational studies including cohort and case-control, cross-sectional studies and case series that reported risk estimates of the association between mental or neurological disorders and COVID-19 susceptibility, illness severity and mortality were included. Two researchers independently extracted data and conducted the quality assessment. Based on I2 heterogeneity, we used a random effects model to calculate pooled odds ratios (OR) and 95% confidence intervals (95% CI). Subgroup analyses and meta-regression analysis were also performed. This study was registered on PROSPERO (registration number: CRD 42021230832). FINDING A total of 149 studies (227,351,954 participants, 89,235,737 COVID-19 patients) were included in this analysis, in which 27 reported morbidity (132,727,798), 56 reported illness severity (83,097,968) and 115 reported mortality (88,878,662). Overall, mental and neurological disorders were associated with a significant high risk of infection (pre-existing mental: OR 1·67, 95% CI 1·12-2·49; and pre-existing neurological: 2·05, 1·58-2·67), illness severity (mental: pre-existing, 1·40, 1·25-1·57; sequelae, 4·85, 2·53-9·32; neurological: pre-existing, 1·43, 1·09-1·88; sequelae, 2·17, 1·45-3·24), and mortality (mental: pre-existing, 1·47, 1·26-1·72; neurological: pre-existing, 2·08, 1·61-2·69; sequelae, 2·03, 1·66-2·49) from COVID-19. Subgroup analysis revealed that association with illness severity was stronger among younger COVID-19 patients, and those with subsequent mental disorders, living in low- and middle-income regions. Younger patients with mental and neurological disorders were associated with higher mortality than elders. For type-specific mental disorders, susceptibility to contracting COVID-19 was associated with pre-existing mood disorders, anxiety, and attention-deficit hyperactivity disorder (ADHD); illness severity was associated with both pre-existing and subsequent mood disorders as well as sleep disturbance; and mortality was associated with pre-existing schizophrenia. For neurological disorders, susceptibility was associated with pre-existing dementia; both severity and mortality were associated with subsequent delirium and altered mental status; besides, mortality was associated with pre-existing and subsequent dementia and multiple specific neurological diseases. Heterogeneities were substantial across studies in most analysis. INTERPRETATION The findings show an important role of mental and neurological disorders in the context of COVID-19 and provide clues and directions for identifying and protecting vulnerable populations in the pandemic. Early detection and intervention for neurological and mental disorders are urgently needed to control morbidity and mortality induced by the COVID-19 pandemic. However, there was substantial heterogeneity among the included studies, and the results should be interpreted with caution. More studies are needed to explore long-term mental and neurological sequela, as well as the underlying brain mechanisms for the sake of elucidating the causal pathways for these associations. FUNDING This study is supported by grants from the National Key Research and Development Program of China, the National Natural Science Foundation of China, Special Research Fund of PKUHSC for Prevention and Control of COVID-19, and the Fundamental Research Funds for the Central Universities.
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Affiliation(s)
- Lin Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Shu-Yu Ni
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Qing-Dong Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Yi-Miao Zhao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Ying-Ying Xu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Huan Mei
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Ying Han
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Jia-Hui Deng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Yan-Kun Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Shi-Qiu Meng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Zheng-Dong Jiang
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Na Zeng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jian-Yu Que
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Yong-Bo Zheng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Bei-Ni Yang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Yi-Miao Gong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | | | - Thomas Kosten
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Xiang-Dong Tang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center and Translational Neuroscience Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Jun-Liang Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Ping Wu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Lin Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
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Andraus M, Thorpe J, Tai XY, Ashby S, Hallab A, Ding D, Dugan P, Perucca P, Costello D, French JA, O'Brien TJ, Depondt C, Andrade DM, Sengupta R, Delanty N, Jette N, Newton CR, Brodie MJ, Devinsky O, Helen Cross J, Li LM, Silvado C, Moura L, Cosenza H, Messina JP, Hanna J, Sander JW, Sen A. Impact of the COVID-19 pandemic on people with epilepsy: Findings from the Brazilian arm of the COV-E study. Epilepsy Behav 2021; 123:108261. [PMID: 34481281 PMCID: PMC8457887 DOI: 10.1016/j.yebeh.2021.108261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/01/2021] [Accepted: 08/02/2021] [Indexed: 12/13/2022]
Abstract
UNLABELLED The COVID-19 pandemic has had an unprecedented impact on people and healthcare services. The disruption to chronic illnesses, such as epilepsy, may relate to several factors ranging from direct infection to secondary effects from healthcare reorganization and social distancing measures. OBJECTIVES As part of the COVID-19 and Epilepsy (COV-E) global study, we ascertained the effects of COVID-19 on people with epilepsy in Brazil, based on their perspectives and those of their caregivers. We also evaluated the impact of COVID-19 on the care delivered to people with epilepsy by healthcare workers. METHODS We designed separate online surveys for people with epilepsy and their caregivers. A further survey for healthcare workers contained additional assessments of changes to working patterns, productivity, and concerns for those with epilepsy under their care. The Brazilian arm of COV-E initially collected data from May to November 2020 during the country's first wave. We also examined national data to identify the Brazilian states with the highest COVID-19 incidence and related mortality. Lastly, we applied this geographic grouping to our data to explore whether local disease burden played a direct role in difficulties faced by people with epilepsy. RESULTS Two hundred and forty-one people returned the survey, 20% were individuals with epilepsy (n = 48); 22% were caregivers (n = 53), and 58% were healthcare workers (n = 140). Just under half (43%) of people with epilepsy reported health changes during the pandemic, including worsening seizure control, with specific issues related to stress and impaired mental health. Of respondents prescribed antiseizure medication, 11% reported difficulty taking medication on time due to problems acquiring prescriptions and delayed or canceled medical appointments. Only a small proportion of respondents reported discussing significant epilepsy-related risks in the previous 12 months. Analysis of national COVID-19 data showed a higher disease burden in the states of Sao Paulo and Rio de Janeiro compared to Brazil as a whole. There were, however, no geographic differences observed in survey responses despite variability in the incidence of COVID-19. CONCLUSION Our findings suggest that Brazilians with epilepsy have been adversely affected by COVID-19 by factors beyond infection or mortality. Mental health issues and the importance of optimal communication are critical during these difficult times. Healthcare services need to find nuanced approaches and learn from shared international experiences to provide optimal care for people with epilepsy as the direct burden of COVID-19 improves in some countries. In contrast, others face resurgent waves of the pandemic.
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Affiliation(s)
- Maria Andraus
- Department of Internal Medicine, Faculty of Medicine, Neurology Service, Epilepsy Program, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Jennifer Thorpe
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK; SUDEP Action, 18 Newbury Street, Wantage, Oxfordshire OX12 8DA, UK
| | - Xin You Tai
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Samantha Ashby
- SUDEP Action, 18 Newbury Street, Wantage, Oxfordshire OX12 8DA, UK
| | - Asma Hallab
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health. Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany
| | - Ding Ding
- Institute of Neurology, Fudan University Huashan Hospital, Shanghai, China
| | - Patricia Dugan
- Department of Neurology, NYU Grossman School of Medicine, USA
| | - Piero Perucca
- Department of Neuroscience, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, Australia & Departments of Medicine and Neurology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Daniel Costello
- Epilepsy Service, Cork University Hospital & College of Medicine and Health, University College Cork, Ireland
| | | | - Terence J O'Brien
- Department of Neuroscience, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, Australia & Departments of Medicine and Neurology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme - Université Libre de Bruxelles, Brussels, Belgium
| | - Danielle M Andrade
- Adult Epilepsy Genetics Program, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | | | - Norman Delanty
- Beaumont Hospital, and School of Pharmacy and Biomolecular Sciences, FutureNeuro Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Nathalie Jette
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Charles R Newton
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK; University Department of Psychiatry, University of Oxford, UK
| | - Martin J Brodie
- Epilepsy Unit, West Glasgow Ambulatory Care Hospital-Yorkhill, Glasgow, UK
| | - Orrin Devinsky
- Department of Neurology, NYU Grossman School of Medicine, USA
| | - J Helen Cross
- UCL NIHR BRC Great Ormond Street Institute of Child Health, London, UK; Young Epilepsy, St Pier's Lane, Dormansland, Lingfield RH7 6P, UK
| | - Li M Li
- Brazilian Institute of Neuroscience and Neurotechnology, Department of Neurology of School of Medical Sciences, Unicamp, Campinas, SP, Brazil
| | - Carlos Silvado
- Comprehensive Epilepsy Program - EEG - Epilepsy Unit - Hospital de Clinicas, Federal University of Parana, Curitiba, PR, Brazil
| | - Luis Moura
- Production Engineering Program, Fuzzy Logic Laboratory - Labfuzzy, Coordination of Post Graduate Engineering Programs - COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Harvey Cosenza
- Production Engineering Program, Fuzzy Logic Laboratory - Labfuzzy, Coordination of Post Graduate Engineering Programs - COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Department of Engineering - REG, Science and Technology Institute - ICT, Fluminense Federal University - UFF, Campus Rio das Ostras, RJ, Brazil
| | - Jane P Messina
- School of Geography and the Environment, University of Oxford, UK; Oxford School of Global and Area Studies, University of Oxford, Oxford, UK
| | - Jane Hanna
- SUDEP Action, 18 Newbury Street, Wantage, Oxfordshire OX12 8DA, UK
| | - Josemir W Sander
- UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG & Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, UK; Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, Netherlands
| | - Arjune Sen
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK.
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Cross JH, Kwon C, Asadi‐Pooya AA, Balagura G, Gómez‐Iglesias P, Guekht A, Hall J, Ikeda A, Kishk NA, Murphy P, Kissani N, Naji Y, Perucca E, Pérez‐Poveda JC, Sanya EO, Trinka E, Zhou D, Wiebe S, Jette N. Epilepsy care during the COVID-19 pandemic. Epilepsia 2021; 62:2322-2332. [PMID: 34428314 PMCID: PMC8652685 DOI: 10.1111/epi.17045] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 02/05/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected the care of all patients around the world. The International League Against Epilepsy (ILAE) COVID-19 and Telemedicine Task Forces examined, through surveys to people with epilepsy (PWE), caregivers, and health care professionals, how the pandemic has affected the well-being, care, and services for PWE. The ILAE included a link on their website whereby PWE and/or their caregivers could fill out a survey (in 11 languages) about the impact of the COVID-19 pandemic, including access to health services and impact on mental health, including the 6-item Kessler Psychological Distress Scale. An anonymous link was also provided whereby health care providers could report cases of new-onset seizures or an exacerbation of seizures in the context of COVID-19. Finally, a separate questionnaire aimed at exploring the utilization of telehealth by health care professionals since the pandemic began was available on the ILAE website and also disseminated to its members. Seventeen case reports were received; data were limited and therefore no firm conclusions could be drawn. Of 590 respondents to the well-being survey (422 PWE, 166 caregivers), 22.8% PWE and 27.5% caregivers reported an increase in seizure frequency, with difficulty in accessing medication and health care professionals reported as barriers to care. Of all respondents, 57.1% PWE and 21.5% caregivers had severe psychological distress (k score >13), which was significantly higher among PWE than caregivers (p<0.01). An increase in telemedicine use during the COVID-19 pandemic was reported by health care professionals, with 40% of consultations conducted by this method. Although 74.9% of health care providers thought that this impacted positively, barriers to care were also identified. As we move forward, there is a need to ensure ongoing support and care for PWE to prevent a parallel pandemic of unmet health care needs.
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Affiliation(s)
- J Helen Cross
- Programme of Developmental NeurosciencesUCL NIHR BRC Great Ormond Street Institute of Child HealthGreat Ormond Street Hospital for ChildrenLondon and Young Epilepsy LingfieldLondonUK
| | - Churl‐Su Kwon
- Division of Health Outcomes and Knowledge Translation ResearchDepartment of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Ali Akbar Asadi‐Pooya
- Epilepsy Research CenterShiraz University of Medical SciencesShirazIran
- Jefferson Comprehensive Epilepsy CenterDepartment of NeurologyThomas Jefferson UniversityPhiladelphiaUSA
| | - Ganna Balagura
- Department of Neurosciences, Rehabilitation, OphthalmologyGenetics, and Maternal and Child HealthPediatric Neurology and Muscular Diseases UnitIRCCS ‘G. Gaslini’ InstituteUniversity of GenoaGenoaItaly
| | - Patricia Gómez‐Iglesias
- Epilepsy Unit. Department of NeurologyHospital Clínico San CarlosHealth Research Institute “San Carlos” (IdISCC)Universidad Complutense de MadridMadridSpain
| | - Alla Guekht
- Moscow Research and Clinical Center for NeuropsychiatryMoscowRussia
- Department of Neurology, Neurosurgery and Medical GeneticsRussian National Research Medical UniversityMoscowRussia
| | - Julie Hall
- Executive DirectorInternational League Against EpilepsyFlower MoundTXUSA
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and PhysiologyKyoto University Graduate School of MedicineKyotoJapan
| | - Nirmeen A. Kishk
- Neurology DepartmentFaculty of MedicineCairo UniversityCairoEgypt
| | | | - Najib Kissani
- Neuroscience Research LaboratoryMarrakech Medical SchoolUniversity Cadi AyyadMarrakeshMorocco
- Neurology DepartmentUniversity Teaching Hospital Mohammed VIMarrakeshMorocco
| | - Yahya Naji
- Neuroscience Research LaboratoryMarrakech Medical SchoolUniversity Cadi AyyadMarrakeshMorocco
- Neurology DepartmentUniversity Teaching Hospital Mohammed VIMarrakeshMorocco
| | - Emilio Perucca
- Division of Clinical and Experimental PharmacologyDepartment of Internal Medicine and TherapeuticsUniversity of PaviaPaviaItaly
- IRCCS Mondino Foundation (and member of the ERN EpiCARE)PaviaItaly
| | - Juan Carlos Pérez‐Poveda
- Neuroscience DepartmentFaculty of MedicineXavierian University, and Hospital Universitario San IgnacioBogotá D. CColombia
| | - Emmanuel O. Sanya
- Neurology division, Medicine DepartmentUniversity of Ilorin Teaching HospitalKwara StateNigeria
| | - Eugen Trinka
- Department of NeurologyCentre for Cognitive NeuroscienceChristian‐Doppler University HospitalParacelsus Medical UniversitySalzburgAustria
- Neuroscience Institute Christian‐Doppler University HospitalCentre for Cognitive NeuroscienceParacelsus Medical UniversitySalzburgAustria
- Institute of Public Health, Medical Decision‐Making and HTA, UMITMedical Informatics and TechnologyPrivate University for Health SciencesHall in TyrolAustria
| | - Dong Zhou
- Department of NeurologyWest China HospitalSichuan UniversityChengduChina
| | - Samuel Wiebe
- Departments of Clinical Neurosciences and Community Health SciencesCumming School of MedicineUniversity of CalgaryCalgaryCanada
| | - Nathalie Jette
- Division of Health Outcomes and Knowledge Translation ResearchDepartment of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
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Mena-Vázquez N, Manrique Arija S, Rojas-Giménez M, Raya-Álvarez E, Velloso-Feijoó ML, López-Medina C, Ramos-Giraldez C, Godoy-Navarrete FJ, Redondo-Rodríguez R, Cabezas-Lucena AM, Morales-Águila M, Romero-Barco CM, Fernández-Nebro A. Hospitalization and mortality from COVID-19 of patients with rheumatic inflammatory diseases in Andalusia. ACTA ACUST UNITED AC 2021; 18:422-428. [PMID: 34538612 PMCID: PMC8426211 DOI: 10.1016/j.reumae.2021.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/18/2021] [Indexed: 11/16/2022]
Abstract
Objective To describe whether rheumatic inflammatory diseases (RID) are associated with a higher risk of hospitalization and/or mortality from COVID-19 and identify the factors associated with hospitalization and mortality in RID and COVID-19 in different Hospitals in Andalusia. Methods Design: Multicentre observational case-COntrol study. Patients: RID and COVID-19 from different centres in Andalusia. Controls: patients without RIS matched by sex, age and CRP-COVID. Protocol A list of patients with PCR for COVID-19 was requested from the microbiology service from March 14 to April 14, 2020. The patients who had RID were identified and then consecutively a paired control for each case. Variables The main outcome variable was hospital admission and mortality from COVID-19. Statistical analysis Bivariate followed by binary logistic regression models (DV: mortality/hospital admission). Results One hundred and fifty-six patients were included, 78 with RID and COVID-19 and 78 without RID with COVID-19. The patients did not present characteristics of COVID-19 disease different from the general population, nor did they present higher hospital admission or mortality. The factor associated with mortality in patients with RID was advanced age (OR [95% CI], 1.1 [1.0–1.2]; P= .025), while the factors associated with hospitalization were advanced age (OR [95% CI], 1.1 [1.0–1.1]; P = .007) and hypertension (OR [95% CI], 3.9 [1.5–6.7]; P = .003). Conclusion Mortality and hospital admission due to COVID-19 do not seem to increase in RID. Advanced age was associated with mortality in RID and, in addition, HTN was associated with hospital admission.
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Affiliation(s)
- Natalia Mena-Vázquez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Sara Manrique Arija
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain.
| | - Marta Rojas-Giménez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain
| | | | | | - C López-Medina
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain
| | | | - Francisco Javier Godoy-Navarrete
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Rocío Redondo-Rodríguez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Alba María Cabezas-Lucena
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - M Morales-Águila
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - C M Romero-Barco
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; Hospital Universitario Virgen de la Victoria de Málaga, Málaga, Spain
| | - Antonio Fernández-Nebro
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain; Departamento de Medicina, Universidad de Málaga, Málaga, Spain
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Anyfantakis D, Mantadaki AE, Mastronikolis S, Spandidos DA, Symvoulakis EK. COVID-19 pandemic and reasons to prioritize the needs of the health care system to ensure its sustainability: A scoping review from January to October 2020 (Review). Exp Ther Med 2021; 22:1039. [PMID: 34373725 PMCID: PMC8343896 DOI: 10.3892/etm.2021.10471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/29/2021] [Indexed: 12/23/2022] Open
Abstract
The worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led the World Health Organization to characterize the pandemic as a public health emergency of international concern. National health care systems in countries during the initial surge of the pandemic were unable to handle the sanitarian crisis that had emerged. Thus, the prevention and control of future global health emergencies must be a priority. The present scoping review aimed to retrieve articles that summarize the current experience on issues related to historical knowledge, and epidemiology, clinical features and overall burden of SARS-CoV-2 on health care services. In summary, a comprehensive overview of the information that has been learnt during this period is presented in the current review. Furthermore, taking into account the global experience, the need for planning cohesive and functional health services before similar pandemic events occur in the future is highlighted. The next public health issue should be prevented rather than treated. In spite of the vaccination benefits, a number of sporadic cases of SARS-CoV-2infections will persist. Information collected remains relevant for appraising how similar threats can be faced in the future. Overall, collaborative health care plans need to be rethought to increase preparedness.
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Affiliation(s)
| | - Aikaterini E. Mantadaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Stylianos Mastronikolis
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Emmanouil K. Symvoulakis
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, 71500 Heraklion, Greece
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von Wrede R, Pukropski J, Moskau-Hartmann S, Surges R, Baumgartner T. COVID-19 vaccination in patients with epilepsy: First experiences in a German tertiary epilepsy center. Epilepsy Behav 2021; 122:108160. [PMID: 34166950 PMCID: PMC8216683 DOI: 10.1016/j.yebeh.2021.108160] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/21/2021] [Accepted: 06/06/2021] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Due to the high demand for information regarding COVID-19 vaccination in people with epilepsy (PWE), we assessed the symptoms and seizure control of PWE following their COVID-19 vaccination. METHODS All adult patients who were treated at our center were asked to report on their vaccination status and, if vaccinated, about their experiences following their first COVID-19 vaccination with regard to adverse effects and seizure control. RESULTS Fifty-four PWE have already received their first vaccination against COVID-19 (27 female, 20% seizure free, 96<% on antiseizure medication) and were included in the study. Two-thirds tolerated the vaccines generally either very well or well. Thirty-three percent reported general vaccination adverse effects. The most frequently reported general adverse effects were, in descending order, headache, fatigue and fever, and shivering. With regard to epilepsy-related adverse effects, one patient reported increased seizure frequency one day after the first COVID-19 vaccination was administered, and one reported the occurrence of a new seizure type. None of the patients reported a status epilepticus or aggravation of preexisting adverse effects. CONCLUSIONS Our data suggest that vaccination against COVID-19 appears to be well tolerated in PWE, supporting the recommendation of vaccination to PWE.
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Affiliation(s)
- Randi von Wrede
- Department of Epileptology, University Hospital of Bonn, Bonn, Germany.
| | - Jan Pukropski
- Department of Epileptology, University Hospital of Bonn, Bonn, Germany
| | | | - Rainer Surges
- Department of Epileptology, University Hospital of Bonn, Bonn, Germany
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Neurological comorbidities and COVID-19-related case fatality: A cohort study. J Neurol Sci 2021; 428:117610. [PMID: 34384971 PMCID: PMC8339457 DOI: 10.1016/j.jns.2021.117610] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/21/2021] [Accepted: 08/02/2021] [Indexed: 11/24/2022]
Abstract
Background Neurological involvement in Coronavirus disease-2019 (COVID-19) is widely recognized. However, the role of pre-existing neurological comorbidities in modulating COVID-19-related mortality still remains unclear. This cohort study evaluates the COVID-19-related case fatality rate (CFR) of patients with pre-existing neurological diseases. Methods We retrospectively evaluated all patients consecutively admitted to our hospital with a diagnosis of COVID-19 between March and April 2020. We used a multivariate regression analysis to estimate the association between pre-existing neurological diseases and COVID-19-related mortality. Then, we compared the CFR and survival curves of two cohorts (patients suffering vs. those not suffering from pre-existing neurological disease), matched trough the propensity score (PS). Age and other comorbidities were considered for PS calculation. We applied a 1:1 matching for the entire neurological cohort and, separately, for cerebrovascular, neurodegenerative, and other neurological diseases. Results Among 332 patients, 75 (22.6%) were affected by pre-existing neurological disease (n = 29 cerebrovascular, n = 26 neurodegenerative, n = 20 others). From the multivariate regression analysis, they resulted with a significant increase of COVID-19-related mortality (OR:2.559; 95%CI 1.181–5.545; p < 0.017). From the cohort analysis, CFR resulted 2-fold higher in patients with neurological disease (48.0% vs. 24.0%; p = 0.002). CFR was significantly higher in patients with neurodegenerative diseases compared to matched individuals (73.9% vs. 39.1%; p = 0.017), while CFR increase in patients with cerebrovascular diseases did not reach statistical significance (48.3% vs. 41.4%; p = 0.597). Conclusions Pre-existing neurological comorbidities, in particular neurodegenerative diseases, increase significantly COVID-19-related case fatality, indicating a clear priority for viral screening, access to care facilities and vaccination in these populations.
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Covid-19 decompensating epilepsy in the elderly: A case report. Ann Med Surg (Lond) 2021; 68:102642. [PMID: 34341685 PMCID: PMC8320423 DOI: 10.1016/j.amsu.2021.102642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 11/24/2022] Open
Abstract
The COVID-19 pandemic has had a great impact on chronic diseases, including epilepsy. The imbalance of antiepileptic drugs in case of intercurrent infection with COVID-19 leads to worsening seizures. A 71-year-old man, followed for post-traumatic epilepsy for 30 years, was stabilized with phenobarbital and topiramate. He presented generalized tonic-clonic epileptic seizures without meningitis. He improved well on midazolam combined with the usual treatment before the diagnosis and worsening of the covid-19. The severity of the lung damage led to hypoxia, recurrence of seizures, and poor prognosis. The association between covid-19 and epilepsy remains pejorative despite management. An epileptic seizure should always be considered as a possible manifestation of COVID-19. The article aimed to establish the relationship between covid-19 and the risk of worsening seizures and to demonstrate the severity of the association between covid-19 and epilepsy in elderly patients. This article establishes the relationship between covid-19 and the risk of worsening seizures. It demonstrates the severity of the association between covid-19 and epilepsy in the elderly. Factors decompensating epilepsy have been studied but such cases are few or not frequent in the literature.
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