Schaefer Bennett Grace, Naik Sunil, Krawiec Conrad
Department of Pediatrics, Penn State Hershey Children's Hospital, Hershey, PA, USA.
Department of Neurology, Penn State Milton Hershey Medical Center, Hershey, PA, USA.
Neurohospitalist. 2024 Jul;14(3):253-258. doi: 10.1177/19418744241232011. Epub 2024 Feb 3.
The coronavirus 2019 (COVID-19) pandemic was associated with catastrophic consequences and increased psychological distress. However, it is unknown if the pandemic impacted the frequency of functional seizures (FS), a well known manifestation of psychiatric disease. The study objectives are to evaluate FS diagnostic code frequency before and during the COVID-19 pandemic and the therapies applied. We hypothesized that FS frequency would be higher during the pandemic, but that the therapies applied would be similar between the two time periods.
This was a retrospective observational cohort study utilizing the TriNetX ® electronic health record (EHR) database. We included subjects aged 8 to 65 years with a diagnostic code of "conversion disorder with seizures or convulsions." After the query, the study population was divided into 2 groups [pre-COVID-19 (3/1/2018 to 2/29/2020) and COVID-19 (3/1/2020 to 2/28/2022). We analyzed subject demographics, diagnostic, procedure, and medication codes.
We included 8680 subjects [5029 (57.9%) pre-COVID-19 and 3651 (42.1%) COVID-19] in this study. There was a higher odds of mental health conditions, anxiolytic prescription, emergency department services, and hospital services, but a lower odds of critical care services during COVID-19. There was no difference in antiepileptic use between the time periods.
During the COVID-19 pandemic, a higher odds of anxiolytic use, need for emergency department services, and hospital services was reported. In addition, there was a decreased odds of critical care services. This may reflect a change in how patients with FS were managed during the pandemic.
2019年冠状病毒病（COVID-19）大流行带来了灾难性后果，并加剧了心理困扰。然而，尚不清楚该大流行是否影响了功能性癫痫发作（FS）的发生频率，FS是一种众所周知的精神疾病表现。本研究的目的是评估COVID-19大流行之前和期间FS诊断代码的频率以及所应用的治疗方法。我们假设在大流行期间FS的频率会更高，但两个时间段所应用的治疗方法会相似。
这是一项利用TriNetX®电子健康记录（EHR）数据库的回顾性观察队列研究。我们纳入了年龄在8至65岁之间、诊断代码为“伴有癫痫发作或抽搐的转换障碍”的受试者。查询后，研究人群被分为两组[COVID-19之前（2018年3月1日至2020年2月29日）和COVID-19期间（2020年3月1日至2022年2月28日）]。我们分析了受试者的人口统计学、诊断、手术和用药代码。
本研究纳入了8680名受试者[COVID-19之前5029名（57.9%），COVID-19期间3651名（42.1%）]。在COVID-19期间，心理健康状况、抗焦虑药物处方、急诊科服务和住院服务的几率更高，但重症监护服务的几率更低。两个时间段之间抗癫痫药物的使用没有差异。
在COVID-19大流行期间，报告的抗焦虑药物使用几率、急诊科服务需求和住院服务需求更高。此外，重症监护服务的几率有所降低。这可能反映了大流行期间FS患者管理方式的变化。
