New onset acute symptomatic seizure and risk factors in coronavirus disease 2019: A retrospective multicenter study

Area of Science:

• Neurology
• Infectious Diseases
• Epidemiology

Background:

• Coronavirus disease 2019 (COVID-19) is a global pandemic with diverse neurological manifestations.
• The potential association between COVID-19 and acute symptomatic seizures requires further investigation.
• Understanding seizure risk in COVID-19 patients is crucial for clinical management.

Purpose of the Study:

• To determine the incidence and risk of acute symptomatic seizures in individuals diagnosed with COVID-19.
• To evaluate whether COVID-19 infection or its associated complications increase seizure risk.
• To clarify the neurological impact of COVID-19 concerning seizure disorders.

Main Methods:

• Multicenter retrospective study involving 304 COVID-19 patients across 42 hospitals in China.
• Data collected from medical records by 11 neurologists using a standardized case report form.
• Exclusion of patients with a prior history of epilepsy; analysis of seizure incidence and risk factors.

Main Results:

• No cases of acute symptomatic seizures or status epilepticus were observed in the studied cohort.
• Two patients experienced seizure-like symptoms attributed to acute stress reaction and hypocalcemia, not directly COVID-19.
• While 27% of patients had conditions predisposing to seizures (e.g., brain insults, metabolic imbalances), these did not translate to increased seizure incidence.

Conclusions:

• There is no evidence to suggest an elevated risk of acute symptomatic seizures in patients with COVID-19.
• Neither the SARS-CoV-2 virus itself nor common COVID-19-related risk factors appear to significantly increase the occurrence of acute symptomatic seizures.
• Further research may be warranted to explore rare neurological presentations, but current data indicate low seizure risk associated with COVID-19.