Status epilepticus and COVID-19: A systematic review

Area of Science:

• Neurology
• Infectious Diseases
• Critical Care Medicine

Background:

• The COVID-19 pandemic, caused by SARS-CoV-2, has been associated with diverse neurological manifestations.
• Reports indicate an increase in acute seizures and status epilepticus (SE) during the pandemic's initial waves.

Purpose of the Study:

• To systematically review and summarize clinical features, diagnostic approaches, and therapeutic strategies for COVID-19-associated status epilepticus (SE).
• To identify factors influencing the severity and mortality of SE in the context of SARS-CoV-2 infection.

Main Methods:

• A systematic literature search was conducted to gather data on patients with COVID-19-related SE.
• Demographic, clinical, neurophysiological, and neuroradiological data were extracted.
• Regression models were employed to identify predictors of SE severity and mortality.

Main Results:

• Thirty-nine articles comprising 47 cases of COVID-19-associated SE were analyzed.
• Higher SE severity was correlated with patient age, the time interval from SARS-CoV-2 infection to SE onset, and hospitalization status.
• Quantitative validated scales were used to assess SE severity.

Conclusions:

• Status epilepticus is a recognized neurological manifestation of SARS-CoV-2 infection.
• The precise pathophysiological mechanisms linking COVID-19 and SE remain under investigation.
• Systemic inflammatory responses, potentially involving cytokine release, may contribute to the development of COVID-19-related SE.