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Incidence and case fatality rate of COVID-19 in patients with active epilepsy
Pablo Cabezudo-García1, Nicolás Lundahl Ciano-Petersen2, Natalia Mena-Vázquez2
1From Instituto de Investigación Biomédica de Málaga (IBIMA) (P.C.-G., N.L.C.-P., N.M.-V., G.P.-P., M.V.C.-S., P.J.S.-C.); and Servicio de Neurología, Unidad de Gestión Clínica de Neurociencias (P.C.-G., N.L.C.-P., G.P.-P., M.V.C.-S., P.J.S.-C.), and Unidad de Gestión Clínica de Reumatología (N.M.-V.), Hospital Regional Universitario de Málaga, Spain. pablocabezudo@gmail.com.
Objective:
This article estimates the incidence and fatality of coronavirus disease 2019 (COVID-19) and identifies potential risk factors for fatality in patients with active epilepsy.
Methods:
This is a cross-sectional observational study of patients with active epilepsy and COVID-19. A control group was used to compare the cumulative incidence and case-fatality rate (CFR). The main outcomes of the study were cumulative incidence, defined as number of patients with active epilepsy and COVID-19 admitted to an emergency department divided by the total number of patients with epilepsy at risk, and CFR based on the number of deaths during the enrollment period. Multiple logistic regression analysis was performed to investigate risk factors for fatality in patients with active epilepsy.
Results:
Of the 1,537 patients who fulfilled the inclusion criteria, 21 (1.3%) had active epilepsy. The cumulative incidence (95% confidence interval [CI]) of COVID-19 in patients with epilepsy was higher (1.2% [0.6-2.4]) compared to the population without epilepsy (0.5% [0.5-0.5]). In reverse transcription PCR-positive patients, there were no significant differences in CFR in patients with active epilepsy compared to patients without epilepsy (33.3% vs 8.3%; p = 0.266). Of the 21 patients with active epilepsy, 5 (23%) died. In multivariate analysis, the factor associated with fatality in patients with active epilepsy was hypertension (odds ratio [OR] 2.8 [95% CI 1.3-21.6]). In another model, age (OR 1.0 [95% CI 1.0-1.1]) and epilepsy (OR 5.1 [95% CI 1.3-24.0]) were associated with fatality during hospitalization.
Conclusion:
COVID-19 cumulative incidence was higher in patients with active epilepsy. Epilepsy was associated with fatality during hospitalization. Hypertension was associated with fatality in patients with epilepsy.
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