Clinical characteristics of 30 COVID-19 patients with epilepsy: a retrospective study in Wuhan

Sun, Minxian; Ruan, Xiaoyun; Li, Yuanyuan; Wang, Pei; Zheng, Shasha; Shui, Guiying; Li, Li; Zhang, Hongmei

Objective This study aims to present clinical characteristics of 30 hospitalized cases with epileptic seizure and coronavirus disease 2019(COVID-19). Methods This is a retrospective observational research. Clinical data were extracted from electronic medical records in 1550 patients with laboratory-confirmed diagnosis of COVID-19 who hospitalized in Wuhan Central Hospital, China, from 1 January to 31 April, 2020. 30 COVID-19 patients with the diagnosis of epilepsy were enrolled. The clinical characteristics, complications, treatments,and clinical outcomes of 30 cases were collected. Result Of 30 patients with diagnosis of epilepsy and COVID-19, 13 patients(43.4%) had new-onset epileptic seizure without epilepsy history(new-onset seizure group,NS group), 10 patients(33.3%) with epilepsy history had recurrent epileptic seizure(recurrent seizure group,RS group) and 7 patients(23.3%) with epilepsy history had no seizure during the course of COVID-19 (epilepsy history group,EH group). Patients in RS group had more other neurological disease history except for epilepsy than those in NS group and EH group(7/10[70%] VS 1/13 [7.7%]VS1/7[14.3%]), and the difference between RS group and NS group is significant (P < 0.05). Patients in NE group and RS group suffered more severe/critical COVID-19 infection than patients in EH group (10/13[76.9%] VS 6/10[60%] VS 1/7[14.3%]),and the difference between NS group and EH group is significant (P < 0.05). 36.7% of patients had 1 to 5 complications,and 46.4% of patients had 6-10 complications.The complications in patients with seizure(in RS group and NS group) seem to be more than those without seizure(in EH group), but it doesn’t have statistic difference. The proportion of antiepileptic drugs (AEDs) treatment before admission was higher in EH group than in RE group(7/7 [100%] VS 2/10 [20%], P < 0.05). The mortality of 30 patients with epilepsy and COVID-19 was 36.67%. The mortality of NS group(38.5%) and RS group(50%) were a little higher than in EH group(14.3%). None of convalescent patients had recurrent seizure, and there was no more death in the 3 month follow-up after discharge. Conclusions COVID-19 Patients with recurrent epileptic seizure had more underlying neurological diseases than patients who had epilepsy history but without seizure.Patients with new-onset and recurrent epileptic seizure suffered more sever/critical COVID-19, which may lead to a worse prognosis.If patients with epilepsy history continue using AEDs during COVID-19 pandemics, the risk of recurrent seizure may reduce, and a good prognosis for patients with epilepsy history could be expected.