Health Scıences Unıversıty Adana Faculty of Medıcıne Adana Cıty Traınıng and Research Hospıtal Neurology Clınıc, Adana, Turkey.
Department of Neurology, Cukurova Unıversıty Faculty of Medıcıne Balcalı Hospıtal, Adana, Turkey.
Acta Neurol Belg. 2023 Oct;123(5):1763-1772. doi: 10.1007/s13760-022-02054-4. Epub 2022 Jul 30.
To assess the prevalence of seizure, associated risk factors, and prognosis in patients with SARS-CoV-2 infection and identify predictive biomarkers in SARS-CoV-2 patients with seizure.
A cohort of 17,806 patients with SARS-CoV-2 infection admitted to two university hospitals in Adana between March 11, 2020 and January 1, 2021 was analyzed retrospectively. The patients' demographic characteristics, laboratory findings, and systemic and neurological symptoms at admission and on the day of seizure onset were evaluated.
Neurological findings were detected in 877 of the 17,806 patients. Of these, 45 patients (0.25%) had seizure (status epilepticus in 4/45 patients, 8.9%). Patients with seizure had a mean age of 55.3 years (range 17-88) and 57.8% were male. Seizure was more common in the 18-44 (24.4%) and ≥ 65 age groups (44.4%) and in those with multiple comorbidity. The case fatality rate for patients with seizure among all SARS-CoV-2 patients was 0.135% (95% CI 80.86-188.71). However, no patient with a previous diagnosis of epilepsy died during SARS-CoV-2 infection. High neutrophil, platelet, and ferritin levels and low lymphocyte and calcium levels on the day of seizure development compared to admission were associated with higher mortality (p = 0.004, 0.008, 0.028, 0003, and 0.002, respectively).
Seizures are not uncommon during SARS-CoV-2 infection, with a higher risk of mortality in older patients and those with higher inflammatory markers.
评估 SARS-CoV-2 感染患者中癫痫发作的患病率、相关危险因素和预后，并确定 SARS-CoV-2 患者癫痫发作的预测生物标志物。
回顾性分析 2020 年 3 月 11 日至 2021 年 1 月 1 日期间在阿达纳的两家大学医院收治的 17806 例 SARS-CoV-2 感染患者的队列。评估患者的人口统计学特征、入院时和癫痫发作当天的实验室检查结果以及全身和神经系统症状。
在 17806 例患者中发现了神经系统表现。其中，45 例（0.25%）出现癫痫发作（45 例患者中有 4 例出现癫痫持续状态，占 8.9%）。有癫痫发作的患者平均年龄为 55.3 岁（范围 17-88 岁），57.8%为男性。癫痫发作更常见于 18-44 岁（24.4%）和≥65 岁年龄组（44.4%），以及合并多种合并症的患者。所有 SARS-CoV-2 患者中癫痫发作患者的病死率为 0.135%（95%CI 80.86-188.71）。然而，在 SARS-CoV-2 感染期间，没有癫痫既往诊断的患者死亡。与入院时相比，癫痫发作当天的中性粒细胞、血小板和铁蛋白水平升高，淋巴细胞和钙水平降低与更高的死亡率相关（p=0.004、0.008、0.028、0.0003 和 0.002）。
SARS-CoV-2 感染期间癫痫发作并不少见，在年龄较大的患者和炎症标志物水平较高的患者中，死亡率更高。
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