Epilepsy and the risk of severe coronavirus disease 2019 outcomes: A systematic review, meta-analysis, and meta-regression

Siahaan, Yusak Mangara Tua; Ketaren, Retno Jayantri; Hartoyo, Vinson; Hariyanto, Timotius Ivan

doi:10.1016/j.yebeh.2021.108437

Cited by 40 publications

(43 citation statements)

References 54 publications

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“…Individuals with certain neurological comorbidities are at risk for an unfavorable course of SARS‐CoV‐2 infection [ 13 , 14 , 15 , 16 , 17 , 18 ]. For instance, a recent meta‐analysis revealed that patients with prior cerebrovascular disease who had a SARS‐CoV‐2 infection had a higher risk of severity (odds ratio [OR] = 3.10, 95% confidence interval [CI] = 2.21–4.36, p < 0.001) and mortality (OR = 3.45, 95% CI = 2.46–4.84, p < 0.001) [ 13 ].…”

Section: Neurological Disorders: a Risk Factor For Detrimental Covid‐...mentioning

confidence: 99%

COVID‐19 vaccination hesitancy among people with chronic neurological disorders: A position paper

Rakuša

Öztürk

Moro

et al. 2022

Euro J of Neurology

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Background and purpose Health risks associated with SARS‐CoV‐2 infection are undisputed. Moreover, the capability of vaccination to prevent symptomatic, severe, and fatal COVID‐19 is recognized. There is also early evidence that vaccination can reduce the chance for long COVID‐19. Nonetheless, the willingness to get vaccinated and receive booster shots remains subpar among people with neurologic disorders. Vaccine scepticism not only jeopardizes collective efforts to end the COVID‐19 pandemic but puts individual lives at risk, as some chronic neurologic diseases are associated with a higher risk for an unfavorable COVID‐19 course. Methods In this position paper, the NeuroCOVID‐19 Task Force of the European Academy of Neurology (EAN) summarizes the current knowledge on the prognosis of COVID‐19 among patients with neurologic disease, elucidates potential barriers to vaccination coverage, and formulates strategies to overcome vaccination hesitancy. A survey among the Task Force members on the phenomenon of vaccination hesitancy among people with neurologic disease supports the lines of argumentation. Results The study revealed that people with multiple sclerosis and other nervous system autoimmune disorders are most skeptical of SARS‐CoV‐2 vaccination. The prevailing concerns included the chance of worsening the pre‐existing neurological condition, vaccination‐related adverse events, and drug interaction. Conclusions The EAN NeuroCOVID‐19 Task Force reinforces the key role of neurologists as advocates of COVID‐19 vaccination. Neurologists need to argue in the interest of their patients about the overwhelming individual and global benefits of COVID‐19 vaccination. Moreover, they need to keep on eye on this vulnerable patient group, its concerns, and the emergence of potential safety signals.

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Section: Neurological Disorders: a Risk Factor For Detrimental Covid‐...mentioning

confidence: 99%

COVID‐19 vaccination hesitancy among people with chronic neurological disorders: A position paper

Rakuša

Öztürk

Moro

et al. 2022

Euro J of Neurology

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“…Epilepsy is one of the most common neurological disorders, affecting more than 70 million people worldwide [13] . A previous study suggested that patients with epilepsy were at a higher risk of experiencing unfavorable COVID-19 outcomes [14] . Taken the widespread of the COVID-19 pandemic, it is urgent to know the benefits and risks of vaccination for patients with epilepsy.…”

Section: Introductionmentioning

confidence: 99%

Should patients with epilepsy be vaccinated against coronavirus disease 2019? A systematic review and meta-analysis

Lin¹,

Huang²,

Fang³

et al. 2022

Epilepsy & Behavior

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confidence: 99%

“…Very early into the COVID-19 pandemic, it became clear that people with preexisting medical conditions, including people with epilepsy, were at greater risk of more severe consequences from COVID-19. 1,2 In this issue of Neurology® , 2 studies address the increased risks associated with COVID-19 for people with epilepsy and the effects the shutdown had on providing epilepsy care. 3,4…”

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confidence: 99%

“…Mortality was higher but not significantly so (9.72% with and 6.48% without epilepsy; OR 1.55, CI 0.65-3.70).The effect sizes reported by Yoo et al 3 are comparable to those from a meta-analysis of studies done during the early part of the COVID-19 pandemic that suggested that severe outcomes were more common in people with than without epilepsy. 2 The study enrolled adults and was performed prior to the availability of any vaccines (January 1-June 4, 2020). A study in children (<21 years of age) and slightly later in the pandemic (March 15, 2020, through December 15, 2020) but still before availability of vaccines found that 21.5% of children hospitalized for PCRpositive COVID-19 developed neurologic involvement during their hospitalization (neuro-COVID).…”

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confidence: 99%

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Epilepsy and COVID-19's Double-Edged Sword

Berg

Jobst

2022

Neurology

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Very early into the COVID-19 pandemic, it became clear that people with preexisting medical conditions, including people with epilepsy, were at greater risk of more severe consequences from COVID-19. 1,2 In this issue of Neurology ® , 2 studies address the increased risks associated with COVID-19 for people with epilepsy and the effects the shutdown had on providing epilepsy care. 3,4 In a thoughtful study of >200,000 adults (>20 years of age) who had PCR SARS-CoV-2 testing in The Republic of Korea, Yoo et al. 3 found that people with epilepsy did not have a higher risk of acquiring SARS-CoV-2 infections (1.84% vs 2.12%; odds ratio [OR] 0.86, 95% CI 0.67-1.11) but those who developed COVID-19 infections had a higher risk of developing serious complications, including intensive care unit admission, mechanical ventilation, and death (18.06% vs 9.72%; OR 2.05, 95% CI 1.04-4.04). Mortality was higher but not significantly so (9.72% with and 6.48% without epilepsy; OR 1.55, CI 0.65-3.70).The effect sizes reported by Yoo et al. 3 are comparable to those from a meta-analysis of studies done during the early part of the COVID-19 pandemic that suggested that severe outcomes were more common in people with than without epilepsy. 2 The study enrolled adults and was performed prior to the availability of any vaccines (January 1-June 4, 2020). A study in children (<21 years of age) and slightly later in the pandemic (March 15, 2020, through December 15, 2020) but still before availability of vaccines found that 21.5% of children hospitalized for PCRpositive COVID-19 developed neurologic involvement during their hospitalization (neuro-COVID). 5 Those with neuro-COVID were more likely to be admitted to the intensive care unit, to require mechanical ventilation or extracorporeal membrane oxygenation, had longer lengths of stay, and were more likely to die or have other serious posthospitalization outcomes. Children at greatest risk for neuro-COVID during admission had preexisting neurologic conditions, the most common of which was epilepsy: 16% with neuro-COVID had epilepsy vs 3% without neuro-COVID.

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Epilepsy and the risk of severe coronavirus disease 2019 outcomes: A systematic review, meta-analysis, and meta-regression

Cited by 40 publications

References 54 publications

COVID‐19 vaccination hesitancy among people with chronic neurological disorders: A position paper

COVID‐19 vaccination hesitancy among people with chronic neurological disorders: A position paper

Should patients with epilepsy be vaccinated against coronavirus disease 2019? A systematic review and meta-analysis

Epilepsy and COVID-19's Double-Edged Sword

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