From Instituto de Investigación Biomédica de Málaga (IBIMA) (P.C.-G., N.L.C.-P., N.M.-V., G.P.-P., M.V.C.-S., P.J.S.-C.); and Servicio de Neurología, Unidad de Gestión Clínica de Neurociencias (P.C.-G., N.L.C.-P., G.P.-P., M.V.C.-S., P.J.S.-C.), and Unidad de Gestión Clínica de Reumatología (N.M.-V.), Hospital Regional Universitario de Málaga, Spain.
Neurology. 2020 Sep 8;95(10):e1417-e1425. doi: 10.1212/WNL.0000000000010033. Epub 2020 Jun 17.
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.
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.
Of the 1,537 patients who fulfilled the inclusion criteria, 21 (1.3%) had active epilepsy. The cumulative incidence (95% confidence interval [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 PCR-positive patients, there were no significant differences in CFR in patients with active epilepsy compared to patients without epilepsy (33.3% vs 8.3%; = 0.266). 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.
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.
本文旨在估算 2019 年冠状病毒病（COVID-19）的发病率和病死率，并确定活动性癫痫患者死亡的潜在危险因素。
这是一项针对活动性癫痫伴 COVID-19 患者的横断面观察性研究。使用对照组比较累积发病率和病死率（CFR）。该研究的主要结局为累积发病率，定义为急诊收治的活动性癫痫伴 COVID-19 患者人数除以处于发病风险的癫痫患者总数；CFR 则基于纳入期间的死亡人数。采用多因素逻辑回归分析，探讨活动性癫痫患者死亡的危险因素。
在符合纳入标准的 1537 例患者中，21 例（1.3%）患有活动性癫痫。癫痫患者 COVID-19 的累积发病率（95%置信区间[CI]）较高（1.2%[0.6-2.4]），而无癫痫患者为 0.5%[0.5-0.5]。在逆转录聚合酶链反应阳性患者中，与无癫痫患者相比，活动性癫痫患者的 CFR 无显著差异（33.3%比 8.3%；P=0.266）。在 21 例活动性癫痫患者中，有 5 例（23%）死亡。多因素分析显示，活动性癫痫患者死亡的相关因素为高血压（比值比[OR]2.8[95%CI 1.3-21.6]）。在另一模型中，年龄（OR 1.0[95%CI 1.0-1.1]）和癫痫（OR 5.1[95%CI 1.3-24.0]）与住院期间的死亡相关。
活动性癫痫患者 COVID-19 的累积发病率较高。癫痫与住院期间的死亡相关。高血压与癫痫患者的死亡相关。
