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新冠疫情期间癫痫患者的长期影响分析:多中心在线调查在各波疫情中的结果。

Long-term analysis of the effects of COVID-19 in people with epilepsy: Results from a multicenter on-line survey across the pandemic waves.

机构信息

Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.

Department of Health Sciences, Università degli Studi di Milano, Milan, Italy; "Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Università degli Studi di Milano, Milan, Italy.

出版信息

Epilepsy Behav. 2022 Oct;135:108900. doi: 10.1016/j.yebeh.2022.108900. Epub 2022 Aug 25.

Abstract

PURPOSE

The worldwide pandemic caused by SARS-CoV-2 virus posed many challenges to the scientific and medical communities, including the protection and management of fragile populations. People with epilepsy (PWE) are a heterogenous group of subjects, with different treatment regimens and severity of symptoms. During the National lockdown, in Italy many patients with chronic conditions lost their regular follow-up program. The aim of this study was to investigate the impact of COVID-19 on their health status, from the start of the pandemic (March 2020) to July 2021 and one year later.

METHODS

We proposed an online questionnaire to subjects followed up at different epilepsy centers located in Milano, Monza & Lodi, three of Lombardy, Northern Italy, the most affected areas by the pandemic. Survey evaluated age, sex, characteristics of patients, type of epilepsy and therapies, COVID-19 diagnosis, vaccines, sleep quality, and anxiety status.

RESULTS

Among 178 analyzed surveys, 37 individuals reported symptoms of COVID-19 in closed contacts, including 9 with molecular diagnosis and 16 PWE performing the nasopharyngeal swab with 3 positive cases. One year later, 35 individuals reported at least one symptom overlapping with those typical of COVID-19, 8 received COVID-19 diagnosis, among which 6 were positive for SARS-CoV-2 infection. According to the sleep quality scale assessment, most PWE (52.3%) had poor sleep quality. Assessing anxiety status, 32 (38.1%) had a pathological score.

CONCLUSION

In this multicenter study, we observed that PWE do not appear to be at a higher risk of severe COVID-19. It will be fundamental monitoring this group to assess possible differences in long-COVID-19 and/or neuro-COVID-19 prevalence. On the other hand, our survey confirmed the impact of the pandemic on anxiety and quality of sleep in PWE. Thus, it is important to promptly recognize and treat psychological distress in PWE, because it could be a risk factor in seizure aggravation and quality-of-life deterioration. Telemedicine appears to be a useful tool to support patients with chronic diseases, such as epilepsy.

摘要

目的

由 SARS-CoV-2 病毒引起的全球大流行给科学界和医学界带来了诸多挑战,其中包括对弱势群体的保护和管理。癫痫患者(PWE)是一组异质性人群,具有不同的治疗方案和症状严重程度。在意大利全国封锁期间,许多患有慢性疾病的患者失去了常规的随访计划。本研究的目的是调查 COVID-19 对他们健康状况的影响,从大流行开始(2020 年 3 月)到 2021 年 7 月,以及一年后。

方法

我们向在位于意大利北部伦巴第大区米兰、蒙扎和洛迪三地的不同癫痫中心接受随访的患者提出了在线问卷。调查评估了年龄、性别、患者特征、癫痫类型和治疗方法、COVID-19 诊断、疫苗接种、睡眠质量和焦虑状况。

结果

在分析的 178 份调查问卷中,有 37 名患者报告在密切接触者中出现 COVID-19 症状,其中 9 名患者接受了分子诊断,16 名患者进行了鼻咽拭子检测,有 3 例阳性。一年后,有 35 名患者报告至少有一种与 COVID-19 典型症状重叠的症状,其中 8 名患者被诊断为 COVID-19,其中 6 例 SARS-CoV-2 感染呈阳性。根据睡眠质量量表评估,大多数 PWE(52.3%)睡眠质量较差。评估焦虑状况时,有 32 名(38.1%)患者的得分存在病理性。

结论

在这项多中心研究中,我们观察到 PWE 似乎没有更高的 COVID-19 重症风险。监测这一人群以评估长 COVID-19 和/或神经 COVID-19 发病率的差异将是至关重要的。另一方面,我们的调查证实了大流行对 PWE 焦虑和睡眠质量的影响。因此,及时识别和治疗 PWE 的心理困扰非常重要,因为它可能是癫痫发作加重和生活质量恶化的一个风险因素。远程医疗似乎是支持癫痫等慢性疾病患者的有用工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d94f/9404228/fbf3f6800aa0/gr1_lrg.jpg

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