Case Control Study of EEG Abnormalities in Hospitalized Patients Investigated for SARS-CoV-2/Covid-19 Infection
Abstract number :
1.161
Submission category :
3. Neurophysiology / 3C. Other Clinical EEG
Year :
2021
Submission ID :
1826286
Source :
www.aesnet.org
Presentation date :
12/4/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:53 AM
Authors :
Shu-wei Hsu, MD - Montefiore Medical Center; Daniel Correa - The Saul R. Korey Department of Neurology; Mitchell Steinschneider - The Saul R. Korey Department of Neurology (Pediatric Neurology), Department of Pediatrics, Dominick P. Purpura Department of Neuroscience; Aristea Galanopoulou, MD PhD, FANA, FAES - Professor, Saul R. Korey Department of Neurology, Dominick P. Purpura, Department of Neuroscience, Isabelle Rapin Division of Child Neurology, Albert Einstein College of Medicine
Rationale: Neurological complications of SARS-CoV-2 infection include seizures and encephalopathy. The prevalence in epileptiform discharges among Covid-19 positive patients varies widely across studies. Most studies lack comparisons with Covid-19 negative patients, and medical confounders are not always considered. We test the hypothesis that the epileptiform discharges are more common in hospitalized patients with Covid-19 infection than in Covid-19 negative.
Methods: In this retrospective unblinded case-control study, clinically indicated EEGs of patients admitted in Jacobi Medical Center between 3/2020 - 6/2020 (first wave) and 12/2020 - 3/2021 and tested for SARS-CoV-2 (second wave) were reviewed. All age groups were included. EEG findings, demographic data, intubation/sedation status, and anti-seizure medication (ASM) use were compared and analyzed with Fisher’s exact test.
Results: There were 162 EEGs in the 1st and 275 in the 2nd wave. We reviewed 52 EEGs from 29 Covid-19 positive and 21 EEGs from 16 Covid-19 negative patients. There were no statistically significant differences in EEG indication, age, gender, history of prior seizure, intubation, or renal dysfunction between groups. There were more patients with hepatic dysfunction in the Covid-19 positive (13/29 vs 2/16, p = 0.0463). There was no significant difference in ASM/sedation exposure which was high in both groups (ASM: 89.47% vs 75%; sedatives: 44.83% vs 43.75%). Both groups demonstrated mainly generalized encephalopathic findings. The incidence of periodic discharges, epileptiform discharges, or EEG seizures was 24.14% in Covid-19 positive vs 18.75% in Covid-19 negative patients, p =1). However, a trend for more epileptiform or periodic EEG discharges or seizures was seen in Covid-19 positive vs Covid-19 negative patients with no prior history of seizures (20.8% vs 9.1% (p=0.64). Both Covid-19 positive and negative cohorts had high mortality rates (34.5% vs 37.5%).
Conclusions: There is a relatively high prevalence of epileptiform abnormalities in the EEG of hospitalized patients who were investigated for Covid-19 infection and underwent clinically indicated EEG studies, but no definite differences based on the Covid-19 status. The elevated clinical severity in these cohorts, common use of ASM/sedatives, and comorbidities are likely confounders. In this case-control series, epileptiform or periodic EEG findings tended to be more common in Covid-19 positive than in negative patients without prior history of seizures which we are currently investigating by increasing the cohort size.
Funding: Please list any funding that was received in support of this abstract.: NINDS RO1 NS091170, U54 NS100064, US Department of Defense W81XWH-18-1-0612, AES.
Neurophysiology