Jagiellonian University Medical College, Faculty of Medicine, Department of Neurology, Krakow, Poland.
University Hospital, Krakow, Poland.
Epilepsy Behav. 2021 Jul;120:107996. doi: 10.1016/j.yebeh.2021.107996. Epub 2021 Apr 24.
The study assessed the prevalence and risk factors for SARS-CoV-2 infection in patients with epilepsy (PWE). Additionally, the course of COVID-19 and its impact on seizure control was investigated.
Subjects with definite (confirmed by positive RT-PCR nasopharyngeal swab or serum anti-SARS-CoV-2 antibodies) and probable COVID-19 were identified via telephone survey among PWE treated at the university epilepsy clinic.
Of 252 screened subjects, 17 (6.7%) had definite and 14 (5.5%) probable COVID-19. The percentage of PWE with definite COVID-19 was much higher than the percentage of subjects with confirmed COVID-19 in Polish general population (3.65%). In the heterogenous population of PWE, including patients with drug-resistant epilepsy, physical/intellectual disability, and comorbidities, we were not able to identify any risk factors for contracting COVID-19. The course of infection was mild or moderate in all subjects, not requiring oxygen therapy or respiratory support. The most common symptoms were fever, fatigue, headaches, muscle aches, and loss of smell/taste and continued for approximately 7-21 days, except for loss of smell/taste which lasted usually several weeks. Seizure exacerbation was noted in only one pregnant patient with confirmed COVID-19 and it was likely related to decreased serum level of levetiracetam in the third trimester.
The study provided reassuring findings related to the low risk of seizure exacerbation in PWE during the course of COVID-19. Patients with epilepsy may be at increased risk of SARS-CoV-2 infection. Epilepsy characteristics are not likely to modify the risk of COVID-19.
本研究评估了癫痫患者(PWE)中 SARS-CoV-2 感染的患病率和危险因素。此外,还研究了 COVID-19 的病程及其对癫痫发作控制的影响。
通过电话调查,在大学癫痫诊所接受治疗的 PWE 中,确定了患有明确(通过鼻咽拭子 RT-PCR 阳性或血清抗 SARS-CoV-2 抗体证实)和可能 COVID-19 的患者。
在筛查的 252 名患者中,有 17 名(6.7%)患有明确的 COVID-19,14 名(5.5%)患有可能的 COVID-19。PWE 中患有明确 COVID-19 的比例远高于波兰普通人群中确诊 COVID-19 的比例(3.65%)。在包括耐药性癫痫、身体/智力残疾和合并症的 PWE 异质人群中,我们无法确定任何感染 COVID-19 的危险因素。所有患者的感染过程均为轻度或中度,不需要氧疗或呼吸支持。最常见的症状是发热、疲劳、头痛、肌肉疼痛和嗅觉/味觉丧失,持续约 7-21 天,除了嗅觉/味觉丧失通常持续数周。仅在一名患有确诊 COVID-19 的孕妇中观察到癫痫发作加重,这可能与孕晚期左乙拉西坦血清水平降低有关。
该研究提供了令人安心的发现,表明在 COVID-19 期间 PWE 癫痫发作加重的风险较低。癫痫患者可能有感染 SARS-CoV-2 的风险增加。癫痫特征不太可能改变 COVID-19 的风险。