Epilepsy Unit, Department of Pediatric Neuroscience. Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy. Member of ERN EpiCARE.
IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy. Member of ERN EpiCARE, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
Epileptic Disord. 2020 Aug 1;22(4):439-442. doi: 10.1684/epd.2020.1175.
The COVID-19 pandemic shook European healthcare systems, with unavoidable gaps in the management of patients with chronic diseases. We describe the impact of the pandemic on epilepsy care in three tertiary epilepsy centres from Spain and Italy, the most affected European countries. The three epilepsy centres, members of the European EpiCARE network, manage more than 5,700 people with epilepsy. In Bologna and Barcelona, the hospitals housing the epilepsy centres were fully converted into COVID-19 units. We describe the reorganization of the clinics and report on the frequency of SARS-CoV-2 in people with epilepsy as well as the frequency of seizures in patients admitted to the COVID units. Finally, we elaborate on critical issues regarding the second phase of the pandemic. The activities related to epilepsy care were reduced to less than 10% and were deprioritized. Discharges were expedited and elective epilepsy surgeries, including vagal nerve stimulator implantations, cancelled. Hospitalizations and EEG examinations were limited to emergencies. The outpatient visits for new patients were postponed, and follow-up visits mostly managed by telehealth. Antiseizure medication weaning plans and changes in vagal nerve stimulator settings were halted. Among the 5,700 people with epilepsy managed in our centres, only 14 tested positive for SARS-CoV-2, without obvious impact on their epilepsy. None of the 2,122 patients admitted to COVID units experienced seizures among the early symptoms. Epilepsy care was negatively impacted by the pandemic, irrespective of COVID-19 epidemiology or conversion of the hospital into a COVID-19 centre. The pandemic did not silence the needs of people with epilepsy, and this must be considered in the planning of the second phase.
新冠疫情冲击了欧洲的医疗体系，慢性病患者的管理也出现了难以避免的疏漏。我们描述了西班牙和意大利三家三级癫痫中心在疫情期间对癫痫护理的影响，这两个国家是欧洲受疫情影响最严重的国家。这三家癫痫中心均为欧洲 EpiCARE 网络的成员，共管理着超过 5700 名癫痫患者。在博洛尼亚和巴塞罗那，设有癫痫中心的医院全部转为新冠定点医院。我们描述了这些中心的重组情况，并报告了癫痫患者中 SARS-CoV-2 的感染率以及入住新冠病房的癫痫患者的癫痫发作频率。最后，我们详细阐述了疫情第二阶段的一些关键问题。癫痫护理相关活动减少到不足 10%，且优先级降低。加快了患者的出院速度，取消了择期癫痫手术（包括迷走神经刺激器植入术）。限制了住院和脑电图检查，仅处理紧急情况。新患者的门诊预约被推迟，主要通过远程医疗来管理随访。抗癫痫药物的逐渐停药计划和迷走神经刺激器设置的更改也停止了。在我们中心管理的 5700 名癫痫患者中，仅有 14 人 SARS-CoV-2 检测呈阳性，但对他们的癫痫没有明显影响。在被收入新冠病房的 2122 名患者中，没有出现早期症状性癫痫发作的情况。无论新冠流行病学或医院是否转为新冠定点医院，疫情都对癫痫护理产生了负面影响。在规划第二阶段时，必须考虑到癫痫患者的需求。
