Incidence and Case Fatality Rate of COVID-19 in Patients with Active Epilepsy

SHORT-FORM ARTICLE

FULL-LENGTH ARTICLE NPub.org/a1fq7m Incidence and case fatality rate of COVID-19 in patients with active epilepsy

Pablo Cabezudo-Garc´ıa, MD, Nicol´as Lundahl Ciano-Petersen, MD, Natalia Mena-V´azquez, PhD, et al. Correspondence Dr. Cabezudo-Garc´ıa Cite as: Neurology 2020;95:e1417-e1425. doi:10.1212/WNL.0000000000010033 ® [email protected]

Study objective This study aimed to estimate the cumulative incidence and Table Predictors of mortality in hospitalized patients in case fatality rate (CFR) of patients with active epilepsy and general and patients with active epilepsy COVID-19. Odds ratio (95% CI) Predictor for mortality p Value

What is known and what this paper adds In all hospitalized patients Patients with epilepsy are at elevated risk of respiratory dis- – eases, especially those related to infections. This investigation Age (per y) 1.07 (1.04 1.09) <0.001 shows that this is true for those with COVID-19. Active epilepsy 5.12 (1.39–24.09) 0.016

Participants and setting In patients with active epilepsy This cross-sectional study includes data from 1,537 patients Hypertension 2.85 (1.37–21.60) 0.027 with COVID-19 admitted to the Hospital Regional Uni- versitario de Málaga(HRUM) in Spain between March 13 and April 12 of 2020, including 21 patients with, and 1,516 controls without, activeepilepsy. Main results and the role of chance The cumulative incidence estimate for patients with Design, size, and duration active epilepsy (1.2%; 95% confidence interval [CI], ThecumulativeincidenceofCOVID-19 in patients with active 0.6%–2.4%)washigherthantheestimateforthegeneral epilepsy was calculated by diving the number of patients with population (0.5%; 95% CI, 0.5%–0.5for the general active epilepsy and COVD-19 admitted to the emergency room population (23.8% vs 3.6%; p < 0.001). Hypertension by the number of patients with active epilepsy at risk; the later predicted greater mortality risks for patients with were estimated by extrapolating to the reference area of the COVID-19 and active epilepsy. Active epilepsy was asso- hospital the results of a recent Spanish population-based epide- ciated with greater mortality in hospitalized patients with miologic study of patients with epilepsy. The CFR was based on COVID-19. the number of deaths during the enrollment period. Cumulative incidence and CFR of COVID-19 in the global population were Bias, confounding, and other reasons calculated using Public Health Spain statistics for the population for caution reference area of the hospital. Stepwise logistic regression was These analyses included few patients with active epilepsy. Not used to identify the predictors of death in patients with active all COVID-19 diagnoses had PCR test results to confirm epilepsy and in hospitalized patients with COVID-19. them. This was a single center study.

Primary outcome measures Study funding/potential competing interests The primary outcomes were the estimated cumulative in- This study was funded by the Fundaci´on Española de cidence of COVID-19 in patients with epilepsy and their case Reumatolog´ıa. Some authors report additional competing fatality rate (CFR). interests. Go to Neurology.org/N for full disclosures.

A draft of the short-form article was written by M. Daleﬁeld, a writer with Editage, a division of Cactus Communications. The corresponding author(s) of the full-length article and the journal editors edited and approved the ﬁnal version.

Copyright © 2020 American Academy of Neurology 431 Copyright © 2020 American Academy of Neurology. Unauthorized reproduction of this article is prohibited. Incidence and case fatality rate of COVID-19 in patients with active epilepsy Pablo Cabezudo-García, Nicolás Lundahl Ciano-Petersen, Natalia Mena-Vázquez, et al. Neurology 2020;95;e1417-e1425 Published Online before print June 17, 2020 DOI 10.1212/WNL.0000000000010033

This information is current as of June 17, 2020

Updated Information & including high resolution figures, can be found at: Services http://n.neurology.org/content/95/10/e1417.full

References This article cites 21 articles, 2 of which you can access for free at: http://n.neurology.org/content/95/10/e1417.full#ref-list-1 Subspecialty Collections This article, along with others on similar topics, appears in the following collection(s): All epidemiology http://n.neurology.org/cgi/collection/all_epidemiology All Epilepsy/Seizures http://n.neurology.org/cgi/collection/all_epilepsy_seizures Permissions & Licensing Information about reproducing this article in parts (figures,tables) or in its entirety can be found online at: http://www.neurology.org/about/about_the_journal#permissions Reprints Information about ordering reprints can be found online: http://n.neurology.org/subscribers/advertise

Neurology ® is the official journal of the American Academy of Neurology. Published continuously since 1951, it is now a weekly with 48 issues per year. Copyright © 2020 American Academy of Neurology. All rights reserved. Print ISSN: 0028-3878. Online ISSN: 1526-632X.