由于新冠疫情而实施的隔离对意大利南部普利亚大区和巴西利卡塔大区 102 名成年癫痫患者癫痫发作频率的影响。
The effect of quarantine due to Covid-19 pandemic on seizure frequency in 102 adult people with epilepsy from Apulia and Basilicata regions, Southern Italy.
机构信息
Epilepsy Centre-S.C. Neurologia Universitaria, Policlinico Riuniti, Foggia, Italy.
Epilepsy Centre-S.C. Neurologia Universitaria, Policlinico Riuniti, Foggia, Italy.
出版信息
Clin Neurol Neurosurg. 2021 Apr;203:106592. doi: 10.1016/j.clineuro.2021.106592. Epub 2021 Mar 2.
OBJECTIVE
following the COVID-19 pandemic, a quarantine was imposed to all of regions Italy by 9th March until 3rd May 2020. We investigated the effect of COVID-19 infection and quarantine on seizure frequency in adult people with epilepsy (PwE) of Apulia and Basilicata regions, Southern Italy.
METHODS
This is an observational, retrospective study based on prospective data collection of 102 successive PWE. The frequency of seizures was evaluated during pre-quarantine (January- February), quarantine (March-April), and post-quarantine period (May-June), while PwE were divided into A) cases responding to treatment with ≤ 1 seizure per year; B) cases responding to treatment with 2-5 seizure per year; C) cases with drug-resistant epilepsy with ≤ 4 seizures per month; D) cases with drug-resistant epilepsy with 5-10 seizures per month. PwE underwent several self-report questionnaires regarding therapeutic compliance, mood, stress and sleep during quarantine period.
RESULTS
Approximately 50 % of PwE showed seizure frequency changes (22.55 % an increase and 27.45 % a reduction) during quarantine. Seizure frequency significantly (p < 0.05) increased in PwE responding to treatment with ≤ 1 seizure per year, while significantly (p < 0.05) reduced in PwE with drug-resistant epilepsy with 5-10 seizures per month. The data was not influenced by therapeutic adherence, sleep and depression. The analysis of anxiety showed a moderate level of anxiety in PwE responding to treatment with < 1 seizure per year, while moderate stress was perceived by all PwE. Seizure frequency changes were related to quarantine, but not to COVID-19 infection. In fact, unlike other regions of Italy, particularly Northern Italy, Apulia and Basilicata regions were less affected by COVID-19 infection, and almost all PwE recognized the quarantine as a stressful event. Emotional distress and anxiety due to social isolation, but also the relative reduction of triggers for epileptic seizures were the most important factors for changes in seizure frequency.
CONCLUSIONS
Our study adds to the growing concern that the indirect effects of COVID-19 pandemic will far outstrip the direct consequences of the infection.
目的
2020 年 3 月 9 日至 5 月 3 日，意大利所有地区都实施了隔离。我们研究了 COVID-19 感染和隔离对意大利南部普利亚和巴西利卡塔地区成年癫痫患者（PwE）发作频率的影响。
方法
这是一项观察性、回顾性研究，基于对 102 例连续 PwE 的前瞻性数据收集。在隔离前（1 月至 2 月）、隔离期间（3 月至 4 月）和隔离后（5 月至 6 月）评估发作频率，同时将 PwE 分为 A）治疗反应良好（每年发作次数≤1 次）的病例；B）治疗反应较好（每年发作次数 2-5 次）的病例；C）药物反应良好（每月发作次数≤4 次）的耐药性癫痫病例；D）药物反应不佳（每月发作次数 5-10 次）的耐药性癫痫病例。在隔离期间，PwE 接受了多项关于治疗依从性、情绪、压力和睡眠的自我报告问卷。
结果
约 50%的 PwE 在隔离期间出现发作频率变化（22.55%增加，27.45%减少）。治疗反应良好（每年发作次数≤1 次）的 PwE 发作频率显著（p<0.05）增加，而药物反应不佳（每月发作次数 5-10 次）的 PwE 发作频率显著（p<0.05）减少。数据不受治疗依从性、睡眠和抑郁的影响。焦虑分析显示，治疗反应良好（每年发作次数<1 次）的 PwE 存在中度焦虑，而所有 PwE 都感到中度压力。发作频率的变化与隔离有关，但与 COVID-19 感染无关。事实上，与意大利其他地区，特别是意大利北部相比，普利亚和巴西利卡塔地区受 COVID-19 感染的影响较小，几乎所有 PwE 都将隔离视为一个压力事件。社交隔离引起的情绪困扰和焦虑，以及癫痫发作诱因的相对减少，是发作频率变化的最重要因素。
结论
我们的研究增加了人们的担忧，即 COVID-19 大流行的间接影响将远远超过感染的直接后果。
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