Impact of the COVID-19 Pandemic on Diagnostic Frequency of Febrile Seizures: An Electronic Health Record Database
Katsiah Cadet1, Gary D Ceneviva2, Vonn Walter3
1Penn State College of Medicine, Hershey, PA, USA.
Insights
Fewer children were diagnosed with febrile seizures during the COVID-19 pandemic, though a higher proportion had complex seizures. Medical interventions remained similar, except for antimicrobial use. Further research on mitigation strategies
Area of Science:
- Pediatric Neurology
- Epidemiology
- Infectious Diseases
Background:
- Febrile seizures are common in children, often linked to viral infections.
- COVID-19 mitigation strategies reduced viral illness transmission.
- The pandemic's impact on febrile seizure frequency requires investigation.
Purpose of the Study:
- To assess the effect of COVID-19 mitigation strategies on febrile seizure diagnostic frequency in children.
- To compare febrile seizure diagnoses and associated medical interventions before and during the pandemic.
Main Methods:
- Retrospective observational cohort study using TriNetX electronic health record data.
- Included children aged 0-5 years diagnosed with febrile seizures.
- Compared data from pre-COVID-19 (April 2019-March 2020) and COVID-19 (April 2020-March 2021) periods.
Main Results:
- Febrile seizure diagnoses decreased by 36.1% during the COVID-19 pandemic.
- A higher proportion of febrile seizures were coded as status epilepticus during the pandemic (2.7% vs 1.6%).
- Hospitalization, lumbar puncture, and critical care codes were similar; antimicrobial use was lower during the pandemic.
Conclusions:
- Fewer children received febrile seizure diagnoses during the COVID-19 pandemic.
- A greater proportion of diagnosed febrile seizures were complex (status epilepticus).
- Further research is needed on mitigation strategies' impact on pediatric viral-associated diseases.
Background And Purpose:
Febrile seizures are common in children and are associated with viral infection. Mitigation strategies implemented during the coronavirus disease 2019 (COVID-19) pandemic have slowed the spread of all viral illnesses potentially impacting febrile seizure frequency. The objective of this study is to assess the impact of COVID-19 mitigation strategies on the diagnostic frequency of febrile seizures.
Methods:
This was a retrospective observational cohort study utilizing TriNetX ® electronic health record (EHR) data. We included subjects aged 0 to 5 years of age reported to have a febrile seizure diagnosis. After the query, the study population was divided into 2 groups [pre-COVID-19 (April 1st, 2019 until March 31st, 2020) and COVID-19 (April 1st, 2020 until March 31st, 2021). We analyzed the following data: age, sex, race, diagnostic, medication, and procedural codes.
Results:
During the pre-COVID time frame, emergency or inpatient encounters made up 688,704 subjects aged 0 to 5 years in the TriNetx database, while in the COVID-19 pandemic time frame, it made up of 368 627 subjects. Febrile seizure diagnosis frequency decreased by 36.1% [2696 during COVID-19 vs 7462 during the pre-COVID-19] and a higher proportion of status epilepticus was coded [72 (2.7%) vs 120 (1.6%)] (P < .001) during the COVID-19 pandemic. Hospitalization, lumbar puncture, critical care services, mechanical ventilation procedural codes were similar between the 2 cohorts. Antimicrobial use was higher in the pre-COVID-19 pandemic group [424 (15.7%) vs 1603 (21.5%)] (P < .001).
Conclusions:
Less children were diagnosed with febrile seizures during the COVID-19 pandemic, but a higher proportion were coded to have the complex subtype. The medical interventions required with the exception of antimicrobial use was similar. Further study is needed regarding mitigation strategies and its impact on pediatric diseases associated with viruses.
Related Concept Videos
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:13Seizures: Classification
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
01:30Methods of Documentation VII: EMR
01:25Increased Body Temperature
01:26Patterns of Fever