Epilepsy mortality in Wales during COVID-19

Area of Science:

• Epidemiology
• Neurology
• Public Health

Background:

• The COVID-19 pandemic has led to increased global mortality, potentially disproportionately affecting individuals with chronic health conditions.
• The impact of the pandemic on mortality rates among people with epilepsy remains largely unknown.
• Understanding these changes is crucial for public health strategies and patient care.

Purpose of the Study:

• To compare mortality rates in people with epilepsy in Wales during the COVID-19 pandemic (2020) with pre-pandemic rates (2015-2019).
• To investigate whether the pandemic altered mortality trends for individuals diagnosed with epilepsy.
• To differentiate between deaths directly associated with epilepsy and overall deaths in people with epilepsy.

Main Methods:

• A retrospective study utilizing linked, anonymised electronic health records from the population of Wales.
• Identification of deaths associated with epilepsy (DAE) and deaths in people with epilepsy (DPWE) using death certificate data.
• Comparison of 2020 death rates with the average rates from 2015-2019 using Poisson models to calculate death rate ratios.

Main Results:

• In 2020, death rates were 7.7/100,000/year for DAE and 25.7/100,000/year for DPWE.
• The death rate ratio for DAE in 2020 compared to 2015-2019 was 1.34 (p<0.001), indicating a significant increase.
• The death rate ratio for DPWE in 2020 was 1.08 (p=0.09), showing no statistically significant increase, with non-COVID deaths for DPWE decreasing slightly (0.96).

Conclusions:

• The observed significant increase in deaths associated with epilepsy (DAE) in Wales during 2020 is likely attributable to the direct impact of COVID-19 infection.
• Non-COVID-19 related deaths in people with epilepsy did not show a significant increase during the study period.
• Further research is necessary to fully understand the longer-term consequences of the pandemic on epilepsy mortality.