COVID‐19 presentations and outcome in patients with epilepsy

Objective To determine whether patients with epilepsy (PWE) are particularly over‐represented in a very large cohort of patients with COVID‐19. We also investigated whether COVID‐19 is associated with a different clinical picture or a more severe course of illness in PWE (compared with others). Meth...

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Bibliographic Details
Published in:Acta Neurologica Scandinavica 2021-06, Vol.143 (6), p.624-628
Main Authors: Asadi‐Pooya, Ali A., Emami, Amir, Akbari, Ali, Javanmardi, Fatemeh
Format: Article
Language:English
Subjects:
Adult
Anorexia
Comorbidity
coronavirus
Cough
COVID
COVID-19
COVID-19 - epidemiology
COVID-19 - physiopathology
Epilepsy
Epilepsy - epidemiology
Female
Humans
Iran - epidemiology
Male
Middle Aged
mortality
Original
seizure
Seizures
Vomiting
Young Adult
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Summary:Objective To determine whether patients with epilepsy (PWE) are particularly over‐represented in a very large cohort of patients with COVID‐19. We also investigated whether COVID‐19 is associated with a different clinical picture or a more severe course of illness in PWE (compared with others). Methods All consecutive patients who referred to and admitted at healthcare facilities anywhere in Fars province (located in the south of Iran with a population of 4,851,000 people) from February 19, 2020 until November 20, 2020 were included. Results A total of 37,968 patients were studied. Eighty‐two patients (0.2%) had pre‐existing epilepsy. Seizures were significantly more frequent among PWE as a presenting manifestation of COVID‐19 compared with that in people without epilepsy (Odds Ratio = 27; p = 0.0001). Furthermore, PWE less often reported cough (significantly) and more often had gastrointestinal symptoms (vomiting and anorexia; as trends) compared with those in people without epilepsy. Patients with epilepsy were not differently likely to be intubated or admitted at ICUs. Case fatality rates were not different between the two groups [9.8% in PWE and 8.5% in people without epilepsy; p = 0.690]. Conclusion Patients with epilepsy are not susceptible to contracting COVID‐19 more than other individuals. Furthermore, COVID‐19 in PWE is not associated with a more severe illness or a poorer prognosis. However, PWE and COVID‐19 may present somewhat differently than others with such an illness. Why PWE less often present with cough and more often present with gastrointestinal symptoms is not clear yet and should be investigated and clarified in the future studies.
ISSN:0001-6314
1600-0404
DOI:10.1111/ane.13404