Risk of hospitalization and death for COVID-19 in persons with epilepsy over a 20-month period: The EpiLink Bologna cohort, Italy.
antiseizure medication (ASM)
epidemiology
epileptic encephalopathy
mortality
outcome
Journal
Epilepsia
ISSN: 1528-1167
Titre abrégé: Epilepsia
Pays: United States
ID NLM: 2983306R
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
revised:
30
06
2022
received:
19
04
2022
accepted:
30
06
2022
pubmed:
3
7
2022
medline:
21
9
2022
entrez:
2
7
2022
Statut:
ppublish
Résumé
Data on COVID-19 outcomes in persons with epilepsy (PWE) are scarce and inconclusive. We aimed to study the risk of hospitalization and death for COVID-19 in a large cohort of PWE from March 1, 2020 to October 31, 2021. The historical cohort design (EpiLink Bologna) compared adult PWE grouped into people with focal epilepsy (PFE), idiopathic generalized epilepsy (PIGE), and developmental and/or epileptic encephalopathy (PDEE), and a population cohort matched (ratio 1:10) for age, sex, residence, and comorbidity (assessed with the multisource comorbidity score), living in the local health trust of Bologna (approximately 800 000 residents). Clinical data were linked to health administrative data. In both cohorts (EpiLink: n = 1575 subjects, 1128 PFE, 267 PIGE, 148 PDEE, 32 other; controls: n = 15 326 subjects), 52% were females, and the mean age was 50 years (SD = 18). Hospital admissions for COVID-19 in the whole period were 49 (3.1%) in PWE and 225 (1.5%) in controls. The adjusted hazard ratio (aHR) in PWE was 1.9 (95% confidence interval [CI] = 1.4-2.7). The subgroups at higher risk were PFE (aHR = 1.9, 95% CI = 1.3-2.8) and PDEE (aHR = 3.9, 95% CI = 1.7-8.7), whereas PIGE had a risk comparable to the controls (aHR = 1.1, 95% CI = .3-3.5). Stratified analyses of the two main epidemic waves (March-May 2020, October 2020-May 2021) disclosed a higher risk of COVID-19-related hospitalization during the first epidemic wave (March-May 2020; aHR = 3.8, 95% CI = 2.2-6.7). Polytherapy with antiseizure medications contributed to a higher risk of hospital admission. Thirty-day risk of death after hospitalization was 14% in both PWE and controls. During the first 20 months since the outbreak of COVID-19 in Bologna, PWE had a doubled risk of COVID-19 hospital admission compared to a matched control population. Conversely, epilepsy did not represent a risk factor for COVID-19-related death.
Identifiants
pubmed: 35778963
doi: 10.1111/epi.17356
pmc: PMC9349826
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2279-2289Informations de copyright
© 2022 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.
Références
J Neurol Neurosurg Psychiatry. 2021 May;92(5):565-566
pubmed: 33158913
Neurology. 2020 Sep 8;95(10):e1417-e1425
pubmed: 32554773
Epilepsia. 2022 Sep;63(9):2279-2289
pubmed: 35778963
Mov Disord. 2021 Jan;36(1):1-10
pubmed: 33196119
Epilepsy Behav. 2021 Jul;120:107996
pubmed: 33957438
PLoS Med. 2015 Oct 06;12(10):e1001885
pubmed: 26440803
Front Neurol. 2020 Dec 18;11:613719
pubmed: 33391172
Front Neurol. 2020 Nov 05;11:576329
pubmed: 33224090
BMJ. 2020 Oct 20;371:m3731
pubmed: 33082154
Lancet Neurol. 2019 May;18(5):459-480
pubmed: 30879893
Front Neurol. 2020 Jul 03;11:737
pubmed: 32719655
Epilepsia. 2020 Sep;61(9):1884-1893
pubmed: 32761900
Front Neurol. 2017 Jul 06;8:301
pubmed: 28729850
BMJ Open. 2017 Dec 26;7(12):e019503
pubmed: 29282274
Epilepsia. 2005;46 Suppl 9:10-4
pubmed: 16302871
MMWR Morb Mortal Wkly Rep. 2020 Apr 17;69(15):465-471
pubmed: 32298250
Sci Rep. 2022 Feb 9;12(1):2214
pubmed: 35140254
Epilepsia. 2021 Oct;62(10):2322-2332
pubmed: 34428314
Epilepsia. 2017 Apr;58(4):512-521
pubmed: 28276062
Front Med (Lausanne). 2021 Sep 01;8:588013
pubmed: 34540855
J Clin Epidemiol. 2008 Apr;61(4):344-9
pubmed: 18313558
Ann Epidemiol. 2021 May;57:14-21
pubmed: 33662494
Epilepsy Behav. 2021 Dec;125:108437
pubmed: 34839246
EClinicalMedicine. 2021 Oct;40:101111
pubmed: 34514362
Epilepsia. 2006 Dec;47(12):2052-7
pubmed: 17201703
Epileptic Disord. 2020 Aug 1;22(4):439-442
pubmed: 32759092
Neurology. 2022 May 10;98(19):e1886-e1892
pubmed: 35338078
J Neurol Sci. 2022 Mar 15;434:120100
pubmed: 34952346
Eur J Neurol. 2020 Apr;27(4):676-684
pubmed: 31838768
Epilepsia. 2014 Apr;55(4):475-82
pubmed: 24730690
Arch Gerontol Geriatr. 2021 Mar-Apr;93:104299
pubmed: 33285424