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In-hospital outcomes in patients with and without epilepsy diagnosed with COVID-19-A cohort study

Claire Ufongene1, Grace Van Hyfte2, Parul Agarwal2,3

  • 1Icahn School of Medicine at Mount Sinai (ISMMS), New York, New York, USA.

Epilepsia
|July 15, 2023
PubMed

Insights

Patients with coronavirus disease 2019 (COVID-19) and epilepsy experienced longer hospital stays and more non-routine discharges. Older age, ventilator use, and comorbidities increased mortality risk in this group.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • Coronavirus disease 2019 (COVID-19) is linked to increased mortality, particularly in individuals with pre-existing conditions.
  • Epilepsy is a common comorbidity that may influence COVID-19 outcomes.

Purpose of the Study:

  • To investigate the in-hospital outcomes of patients diagnosed with COVID-19, comparing those with and without epilepsy.
  • To identify factors associated with mortality and non-routine discharge in COVID-19 patients with epilepsy.

Main Methods:

  • A retrospective study analyzed data from 9833 COVID-19 patients admitted between March 2020 and May 2021.
  • Epilepsy was identified using a validated ICD-9-CM/ICD-10-CM case definition.
  • Logistic regression and Kaplan-Meier analyses assessed mortality and discharge status; ordinary least-squares regression evaluated length of stay.

Main Results:

  • Patients with epilepsy (n=334) showed higher rates of ventilator use, ICU admission, mortality, and longer length of stay (LOS) on univariate analysis compared to those without epilepsy.
  • Multivariate analysis revealed significantly higher odds of non-routine discharge (aOR 2.70) and longer LOS (32.50%) in patients with epilepsy.
  • Factors associated with increased mortality in epilepsy patients included older age (≥65), ventilator support, and higher Charlson Comorbidity Index (CCI).

Conclusions:

  • Individuals with COVID-19 and epilepsy had increased odds of non-routine discharge and longer LOS, but not significantly higher mortality.
  • Older adults with epilepsy and multiple comorbidities represent a vulnerable population requiring close monitoring during COVID-19 outbreaks.
  • These findings highlight the need for tailored care strategies for COVID-19 patients with epilepsy, particularly those with advanced age and significant comorbidities.
Abstract

Keywords:
COVID-19comorbidityhospital outcomesneurologicalseizure

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