In-Hospital Outcomes in Patients with and without Epilepsy Diagnosed with COVID-19
Abstract number :
1.37
Submission category :
16. Epidemiology
Year :
2021
Submission ID :
1826586
Source :
www.aesnet.org
Presentation date :
12/4/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:54 AM
Authors :
Claire Ufongene, BA - Icahn School of Medicine at Mount Sinai; Jung-Yi Lin – Icahn School of Medicine at Mount Sinai; Jonathan Goldstein – Icahn School of Medicine at Mount Sinai; Brian Mathew – Icahn School of Medicine at Mount Sinai; Allison Navis – Icahn School of Medicine at Mount Sinai; Louise McCarthy – Icahn School of Medicine at Mount Sinai; Leah Blank – Icahn School of Medicine at Mount Sinai; Ariella Cohen – Icahn School of Medicine at Mount Sinai; Mandip Dhamoon – Icahn School of Medicine at Mount Sinai; Pojen Deng – Icahn School of Medicine at Mount Sinai; Kapil Guruangan – Icahn School of Medicine at Mount Sinai; Eveline Gutzwiller – Icahn School of Medicine at Mount Sinai; Qing Hao – Icahn School of Medicine at Mount Sinai; Celestine He – Icahn School of Medicine at Mount Sinai; Wilson Heredia Nunez – Icahn School of Medicine at Mount Sinai; Britany Klenofsky – Icahn School of Medicine at Mount Sinai; Benjamin Kummer – Icahn School of Medicine at Mount Sinai; Hernan Lemus – Icahn School of Medicine at Mount Sinai; Lara Marcuse – Icahn School of Medicine at Mount Sinai; Veronica Peschansky – Icahn School of Medicine at Mount Sinai; Emily Schorr – Icahn School of Medicine at Mount Sinai; Anuradha Singh – Icahn School of Medicine at Mount Sinai; Gabriella Tantillo – Icahn School of Medicine at Mount Sinai; James Young – Icahn School of Medicine at Mount Sinai; Parul Agarwal – Icahn School of Medicine at Mount Sinai; Priti Balchandani – Icahn School of Medicine at Mount Sinai; Joanne Festa – Icahn School of Medicine at Mount Sinai; Georges Naasan – Icahn School of Medicine at Mount Sinai; Churl-Su Kwon – Icahn School of Medicine at Mount Sinai; Alexander Charney – Icahn School of Medicine at Mount Sinai; Girish Nadkarni – Icahn School of Medicine at Mount Sinai; Nathalie Jette – Icahn School of Medicine at Mount Sinai
Rationale: COVID-19 can affect a variety of organ systems. Those with pre-existing conditions are at a greater risk of mortality if infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Neurological symptoms associated with COVID-19 have been reported but there are limited data regarding outcomes in those with pre-existing neurological conditions, including epilepsy. As epilepsy is associated with a higher risk of premature mortality, we hypothesized that compared to patients without epilepsy, patients with COVID-19 and epilepsy would have higher rates of hospital mortality and worse outcomes despite adjustments for confounders. Thus, the aim of this study was to evaluate hospital outcomes, including mortality, in patients admitted with COVID-19 with and without epilepsy.
Methods: We conducted a retrospective study in a large multicenter New York health system comparing outcomes in patients with and without epilepsy admitted with COVID-19 between March 15, 2020 and May 17, 2021. Patients with epilepsy were identified using a validated ICD-9-CM and ICD-10-CM based case definition. Outcomes included level of respiratory support (i.e., none, nasal flow cannula/mask, non-rebreather/high flow nasal flow cannula, BIPAP/CPAP, ventilator), ICU admission, and in-hospital mortality. Descriptive statistics were calculated. Chi-squared tests and t-tests were conducted to compare the demographics and outcomes between patients with and without epilepsy. Analyses adjusting for confounders (i.e. sociodemographic variables, comorbidities, COVID severity, calendar month, therapies received, serological markers and others) are in progress. Univariate analyses are presented below.
Results: We identified 334 COVID-19 patients with and 9,499 without epilepsy. Patients with epilepsy were significantly younger than patients without epilepsy (mean 62 vs. 65 years old, p=0.02). Of those with epilepsy, 45% were female compared to 46% in those without epilepsy (p=0.674). Although there were more non-Hispanic Asians without epilepsy (5.7% vs 3.6%) and more non-Hispanic Blacks with epilepsy (27.8 vs 24.5%), race was not statistically different between the two groups. Patients with epilepsy had a significantly higher rate of ventilator respiratory support than those without epilepsy (37.7% vs. 14.3%, p < 0.001). Eighteen percent of patients with and without epilepsy were admitted to the ICU (epilepsy vs without epilepsy: 39.2% vs. 17.7%, p < 0.001). There was a significant difference in in-hospital mortality between patients with or without epilepsy (29.6% vs 19.9% respectively, p < 0.001).
Epidemiology