Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, Affiliated partner of the ERN EpiCARE, Salzburg, Austria.
Centre of Neuroscience, Christian Doppler University Hospital Salzburg, Salzburg, Austria.
Epilepsia. 2020 Dec;61(12):e198-e203. doi: 10.1111/epi.16737. Epub 2020 Nov 2.
Several emergencies were admitted less frequently to the hospital during the coronavirus disease 2019 (COVID-19) pandemic. To investigate whether this also occurred with status epilepticus (SE) we compared admissions due to first SE from March to April 2020 ("Time of COVID," TOC) with January to February 2020 ("pre-COVID," preCOV). We also compared admission numbers in TOC and preCOV with the respective 2-month periods in 2018 and 2019 in a retrospective cohort analysis. Two investigators independently searched the hospital patient database for various forms of SE. There was no significant change in the 2-month incidences of first SE in the city of Salzburg from preCOV of 6.1 (95% confidence interval [CI] 2.9-12.3) to TOC of 6.9/100 000 adults (95% CI 3.4-13.3). Admission numbers did not differ significantly from previous years. Estimated adjusted incidence was in line with a recent 5-year epidemiological study in Salzburg. However, a trend toward less-frequent nonconvulsive SE (NCSE) and loss of female predominance were indirect hints of underdiagnosing SE. In contrast to other medical conditions, SE most often presents clinically with impaired consciousness, which may promote admission to emergency departments even in times of lock-down. Further research of medical support of women and patients with NCSE during pandemic-related restrictions is warranted.
在 2019 年冠状病毒病(COVID-19)大流行期间,医院收治的几种急症患者较少。为了研究癫痫持续状态(SE)是否也存在这种情况,我们将 2020 年 3 月至 4 月(“COVID 时期”,TOC)首次 SE 入院的患者与 2020 年 1 月至 2 月(“COVID 前”,preCOV)入院的患者进行了比较。我们还在回顾性队列分析中,将 TOC 和 preCOV 的入院人数与 2018 年和 2019 年相应的 2 个月期间进行了比较。两名研究人员独立搜索了医院患者数据库中各种形式的 SE。萨尔茨堡市 COVID 前的前 2 个月首次 SE 的发病率从 6.1(95%置信区间 [CI] 2.9-12.3)无显著变化为 TOC 的 6.9/100 000 成年人(95% CI 3.4-13.3)。入院人数与前几年无显著差异。估计调整后的发病率与萨尔茨堡最近的一项 5 年流行病学研究一致。然而,NCSE 不那么频繁和女性优势丧失的趋势是间接暗示 SE 漏诊的迹象。与其他医疗条件不同,SE 最常表现为意识障碍,即使在封锁期间,这也可能促使患者前往急诊室。需要进一步研究大流行相关限制期间对女性和 NCSE 患者的医疗支持。