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Risk of COVID-19 Infection and of Severe Complications Among People With Epilepsy: A Nationwide Cohort Study

 Joonsang Yoo  ;  Jee Hyun Kim  ;  Jimin Jeon  ;  Jinkwon Kim  ;  Tae-Jin Song 
 NEUROLOGY, Vol.98(19) : e1886-e1892, 2022-05 
Journal Title
Issue Date
COVID-19 Testing ; COVID-19* / complications ; COVID-19* / epidemiology ; Cohort Studies ; Epilepsy* / epidemiology ; Humans ; SARS-CoV-2
Background and objectives: The goal of this work was to evaluate whether patients with epilepsy were more susceptible to coronavirus disease 2019 (COVID-19) infection and at greater risk of severe complications when infected with COVID-19 compared with patients without epilepsy.

Methods: We included participants who underwent at least 1 severe acute respiratory syndrome coronavirus 2 real-time reverse-transcription PCR test between January 1 and June 4, 2020, from the Korean nationwide COVID-19 dataset. Epilepsy was defined according to the presence of diagnostic code in health claims data before the COVID-19 diagnosis. To investigate the association between epilepsy and the susceptibility for or severe complications of COVID-19, a 1:6 ratio propensity score matching (PSM) and logistic regression analysis were performed. Severe complications with COVID-19 infection were defined as a composite of the incidence of mechanical ventilation, intensive care unit admission, and death within 2 months after COVID-19 diagnosis.

Results: Among 212,678 study participants who underwent a COVID-19 test, 3,919 (1.8%) had a history of epilepsy. After PSM, there was no significant difference in COVID-19 PCR positivity according to epilepsy history (odds ratio [OR] 0.86, 95% CI 0.67-1.11). Of the 7,713 individuals with confirmed COVID-19 infection, 72 (0.9%) had a history of epilepsy. Among the patients with COVID-19, severe complications occurred in 444 (5.8%) individuals. After PSM, the presence of epilepsy was associated with the occurrence of severe complications after COVID-19 infection (OR 2.05, 95% CI 1.04-4.04). Mortality after COVID-19 infection did not differ according to the presence of epilepsy history (OR 1.55, 95% CI 0.65-3.70).

Discussion: The presence of epilepsy was not associated with increased susceptibility to COVID-19 infection or mortality related to the infection. However, there was an increased risk of severe complications with COVID-19 in patients with epilepsy; therefore, careful management and monitoring may be necessary.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jinkwon(김진권) ORCID logo https://orcid.org/0000-0003-0156-9736
Yoo, Joon Sang(유준상) ORCID logo https://orcid.org/0000-0003-1169-6798
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