Department of Neuroscience Rehabilitation Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Largo Daneo 3, 16132, Genova, Italy.
IRCCS Ospedale Policlinico San Martino, Division of Clinical Neurophysiology, Genova, Italy.
Neurol Sci. 2022 Nov;43(11):6159-6166. doi: 10.1007/s10072-022-06354-8. Epub 2022 Aug 27.
During the COVID-19 pandemic, electroencephalography (EEG) proved to be a useful tool to demonstrate brain involvement. Many studies reported non-reactive generalized slowing as the most frequent pattern and epileptiform activity in a minority of patients.
To investigate the prevalence of diffuse unreactive background attenuation or suppression and its correlation with outcome in a cohort of COVID-19 patients.
The EEGs recorded during the first year of the COVID-19 pandemic were retrospectively evaluated to identify the main pattern and focus on the occurrence of a low-voltage background, either attenuated (10-20 μV) or suppressed (< 10 μV). We sought a correlation between in-hospital mortality and low-voltage EEG. In a subsample of patients, biomarkers of inflammation, hypoxemia and organ failure were collected. Brain imaging was also evaluated.
Among 98 EEG performed in 50 consecutive patients, diffuse unreactive slowing was the most prevalent pattern (54%), followed by unreactive attenuation or suppression pattern (26%), being the latter significantly correlated with an unfavourable outcome (p = 0.0004). Survivors showed significantly lower interleukine-6 values compared to non-survivors. Patients with attenuated EEG and non-survivors also showed lower PaO/FiO values. Neuroradiological findings were very heterogeneous with a prevalence of lesions suggestive of a microangiopathic substrate.
EEG attenuation or suppression may be more frequent than previously reported and significantly associated with a poor outcome. SARS-CoV-2 infection may result in encephalopathy and reduced EEG voltage through mechanisms that are still unknown but deserve attention given its negative impact on prognosis.
在 COVID-19 大流行期间，脑电图（EEG）被证明是一种有用的工具，可以显示脑部受累情况。许多研究报告称，非反应性广泛减速是最常见的模式，而少数患者出现癫痫样活动。
调查 COVID-19 患者队列中弥漫性无反应性背景衰减或抑制的发生率及其与结局的相关性。
回顾性评估 COVID-19 大流行第一年期间记录的 EEG，以确定主要模式，并重点关注低电压背景的发生，无论是衰减（10-20μV）还是抑制（<10μV）。我们试图确定住院死亡率与低电压 EEG 之间的相关性。在患者的亚组中，收集了炎症、低氧血症和器官衰竭的生物标志物。还评估了脑成像。
在 50 例连续患者中进行的 98 次 EEG 中，弥漫性无反应性减速是最常见的模式（54%），其次是无反应性衰减或抑制模式（26%），后者与不良结局显著相关（p=0.0004）。幸存者的白细胞介素-6 值明显低于非幸存者。表现为衰减性 EEG 的患者和非幸存者的 PaO/FiO 值也较低。神经放射学发现非常多样化，存在提示微血管病基础病变的病变。
与之前报道相比，EEG 衰减或抑制可能更为常见，且与不良结局显著相关。SARS-CoV-2 感染可能通过尚不清楚的机制导致脑病和脑电图电压降低，但鉴于其对预后的负面影响，值得关注。
