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Neurology . Risk of COVID-19 Infection and of Severe Complications Among People With Epilepsy: A Nationwide Cohort Study

tetano

Editor, Senior Moderator
Neurology


. 2022 Mar 25;10.1212/WNL.0000000000200195.
doi: 10.1212/WNL.0000000000200195. Online ahead of print.
Risk of COVID-19 Infection and of Severe Complications Among People With Epilepsy: A Nationwide Cohort Study


Joonsang Yoo[SUP] 1 [/SUP], Jee Hyun Kim[SUP] 2 [/SUP], Jimin Jeon[SUP] 1 [/SUP], Jinkwon Kim[SUP] 1 [/SUP], Tae-Jin Song[SUP] 2 [/SUP]



Affiliations

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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