Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.
Chalfont Centre for Epilepsy, Chalfont St. Peter, UK.
Acta Neurol Scand. 2021 Apr;143(4):389-395. doi: 10.1111/ane.13405. Epub 2021 Feb 11.
To understand the risks, impact and outcome of COVID-19 in people affected by Dravet Syndrome (DS).
An anonymous cross-sectional online survey was conducted between June 17 and July 13, 2020, addressed to families of people with DS.
A total of 116 responses were collected, from families of children (n = 86; 74%) and adults (30; 26%) with DS. The majority (106; 91%) were shielded at the family home during lockdown. Symptoms compatible with COVID-19 were reported in 22 (19%) individuals. Only four individuals with symptoms had a PCR swab test, none of which was positive. Only one symptomatic person had antibody testing (but not swab testing), which was positive. One person had repeatedly positive swab tests whilst in hospital for renal failure, but had no typical symptoms of COVID-19. In 50% of people with DS who developed possible or probable COVID-19 symptoms, seizure worsening was reported, in terms of increased seizure frequency or duration or both. Medical attention was required in 9/22 (41%), all of whom were children.
In this cohort of people with DS, we observed an infection rate, determined by compatible symptoms, of 19%, with no deaths and benign outcome in most cases despite the underlying complex epilepsy although children often required medical attention. Early adoption of preventative measures, including testing of symptomatic individuals, regular surveillance for people living in residential care facilities, and shielding of individuals with comorbidities increasing the risk of severe outcome, may limit the impact of COVID-19.
了解 COVID-19 对患有德拉维特综合征(DS)的人群的风险、影响和结局。
2020 年 6 月 17 日至 7 月 13 日,我们针对 DS 患者的家庭,开展了一项匿名的横断面在线调查。
共收集到 116 份回复,来自 DS 患儿(n=86;74%)和成人(n=30;26%)家庭。在封锁期间,大多数(106;91%)家庭都将患者留在了家中。报告称有 22 例(19%)患者出现了与 COVID-19 相符的症状。仅有 4 例有症状的个体接受了 PCR 拭子检测,结果均为阴性。仅有 1 例有症状的个体接受了抗体检测(而非拭子检测),结果为阳性。1 例因肾衰竭住院的患者,反复拭子检测呈阳性,但无 COVID-19 的典型症状。在出现可能或确诊 COVID-19 症状的 DS 患者中,50%报告了癫痫恶化,表现为发作频率或持续时间增加,或两者均增加。22 例患者中有 9 例(41%)需要医疗关注,均为儿童。
在本队列中,我们观察到,以相符症状为依据,DS 患者的感染率为 19%,尽管大多数患者存在基础的复杂癫痫,但无死亡病例且结局通常良好,然而儿童往往需要医疗关注。早期采取预防措施,包括对有症状的个体进行检测、对居住在护理院的患者进行常规监测、以及对有增加严重后果风险的合并症患者进行隔离,可能会限制 COVID-19 的影响。