People who have had COVID-19 are more likely to have seizures or seizures. epilepsy After being infected than comrades who had influenzasuggests a new study.
In an analysis of more than 300,000 individuals, those infected with COVID were 66% more likely than those infected with the flu to develop epilepsy or seizures six months after infection.
The risk was highest in children and those not hospitalized with COVID, researchers report.
“The overall risk of developing seizures and epilepsy was low, less than 1% of all people infected with COVID-19, but given the large number of people infected with COVID-19, this It may lead to an increase in the number of infected people, with seizures and epilepsy,” said principal investigator Arjune Sen, MD, PhD, associate professor at the University of Oxford and head of the Oxford Epilepsy Study Group, News. mentioned in the release.
Here are the findings: publish online November 16th Neurology.
“Confusing” Literature
The literature on post-COVID seizures is ‘somewhat confusing,’ Sen said Medscape medical news.
“Especially early in the pandemic, there have been small case reports or small case series suggesting that seizures may occur following COVID-19, but the dramatic spread of seizures in clinics among infected people has increased. We didn’t see any significant increase,” he said.
Researchers therefore set out to “define whether there was indeed a link between COVID-19 and epilepsy and seizures,” Sen noted.
They looked at an electronic health record (EHR) network that covers 81 million people and compared COVID-infected patients with flu-infected patients. In each cohort, researchers analyzed seizure and epilepsy incidence and hazard ratios (HR). They stratified the data by age and whether patients were hospitalized for acute infections.
They also “examined time-varying HR to assess temporal patterns of seizure or epilepsy diagnosis,” the researchers report.
Of the 890,934 EHRs, two cohorts (n = 152,754 each) were reached. These cohorts were “closely matched” in both psychiatric and medical demographics and comorbidities. Covariates included age, gender, race, ethnicity, comorbidities and lifestyle factors.
The primary outcome was the 6-month incidence of the composite endpoint of epilepsy or seizures, and secondary outcomes included seizures and epilepsy separately.
In secondary analyses, we divided the overall group into pediatric (<16 years old) and adult (>16 years old) participants, and participants who were hospitalized for COVID versus those who were not hospitalized.
Watch out for mild seizures
Results showed an increased incidence of a composite endpoint of seizures or epilepsy in COVID compared to the influenza cohort. Assessing seizures and epilepsy separately also increased the risk of each outcome.
| the last stop | 6-month cumulative incidence (COVID vs influenza) | HR (95% CI) | P. worth |
|---|---|---|---|
| composite | 0.94% vs 0.60% | 1.55 (1.40 – 1.72) | < .0001 |
| seizure | 0.81% vs 0.52% | 1.55 (1.39 – 1.74) | < .0001 |
| epilepsy | 0.30% vs 0.17% | 1.87 (1.54 – 2.28) | < .0001 |
When the researchers stratified the analysis by age, they found an increased risk for the composite endpoint in children as in adults, although the increased risk was greater in children.
| Age group | 6-month cumulative incidence (COVID vs influenza) | HR (95% CI) | P. worth |
|---|---|---|---|
| child | 1.34% vs 0.69% | 1.85 (1.54 – 2.22) | < .0001 |
| adult | .84% vs. 0.54% | 1.56 (1.37 – 1.77) | < .0001 |
The risk of post-COVID epilepsy was ‘significantly attenuated by age, more pronounced in children than in adults’ compared to influenza (mitigation coefficient, 0.68; 95% CI, 0.23–1.13; P. = .0031), researchers report.
The risk for the combined endpoint was greater for those who were hospitalized than those who were not hospitalized after COVID and influenza.
| hospitalization | Six-month cumulative incidence (COVID-19 vs. influenza) | HR (95% CI) | P. worth |
|---|---|---|---|
| yes | 0.72% vs 0.48% | 1.44 (1.27 – 1.63) | < .0001 |
| No | 2.90% vs 2.40% | 1.14 (0.95 – 1.38) | < .16 |
Hospitalization status was not a significant modifier (adjustment coefficient, 0.12; 95% CI, -0.10 to 0.35; P. = .28) for composite endpoints.
On the other hand, hospitalization status was a significant modifier of the association between COVID and epilepsy, with a ‘more pronounced’ association among non-hospitalized patients (adjustment coefficient, 0.52; 95% CI, 0.11 – 0.93; P. = .012).
A post hoc analysis showed that the peak time for HR for the composite endpoint between COVID and influenza was 23 days post-infection, 21 days in adults only, and 50 days in children. However, at 50 days post-infection, the child was almost three times more likely to have a combined endpoint after her COVID and flu.
There was also an important difference between hospitalized and non-hospitalized patients, with HR for the composite endpoint peaking at 9 vs. 41 days, respectively. At that point, the non-hospitalized participant was more than twice as likely to be diagnosed with seizures or epilepsy after COVID-19 as she was after the flu.
“We found that the overall rate of seizures after COVID was low, which is consistent with what we have seen clinically. said Sen.
He suggested that clinicians “need to be aware that this can occur and that it can present as a milder seizure in which people do not lose consciousness or exhibit any unusual symptoms.”
The findings also “highlight an increased risk for children,” Sen said. ‘, said the child should be vaccinated.
Continuous Prevention, Greater Attention
Comments on Medscape Medical News, Dr. Wyatt Bensken, Adjunct Assistant Professor of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, said: He continues to advocate for lasting effects and preventative measures. ”
Bensken, co-author of Accompanying editorialwas not involved in the study.
Recognition of the long-term risk of developing seizures among COVID-infected individuals “should call for continued prevention of infection and greater attention to persistent neurological symptoms and disease,” he said. he pointed out.
“Importantly, we must recognize that the risk of COVID-19 infection is and remains unequally distributed among the population,” Bensken said.
“Studies like this highlighting the neurological impact of COVID-19 infection will strengthen efforts to address these drivers of inequality,” he added.
This study was funded by the Oxford Health Biomedical Research Center, National Institutes of Health. Investigators did not report any related financial relationships. Bensken serves on the editorial board of the journal Neurology and has received research funding from the National Institute on Minority Health and Health Disparities of the National Institute of Health. Other editors’ disclosures are in the original article.
Neurology. Published online on November 16, 2022. Full article, editorial
Batya Swift Yasgur MA, LSW is a freelance writer in counseling in Teaneck, NJ. She is a regular contributor to numerous medical publications, including Medscape and her WebMD, as well as consumer health books and publications such as Behind the Burqa: Our Lives in Afghanistan and How We Escaped to Freedom. Memoirs of a Brave Afghan Sister Who Told Her).
For more Medscape Neurology news, visit Facebook When twitter.
