The impact of COVID-19 on patients with epilepsy

Data from a questionnaire on the repercussions of COVID-19 were analyzed in relation to the clinical variables of 114 PWE, with a significance level of p<0.05.

Results:

There were 26 cases of COVID-19 in PWE and/or family members (22.8%). During the pandemic period, 11 PWE (9.6%) reported an increase in seizures, but unrelated to COVID-19. Also, the number of crises in PWE with previous depressive disorders increased, with differences between epilepsies. Symptoms of depression, impaired well-being, and concern for their lifestyle were significant in PWE with a previous diagnosis of depression. Impaired well-being, increased anxiety, nervousness, and tiredness, and the concern with being infected were mentioned by a high number of PWE in the pandemic.

Conclusion:

Seizure frequency increased during the pandemic period, a finding associated with clinical variables of epilepsy. PWE with depression had worse perceived well-being. Changes in well-being and increased anxiety and nervousness were frequent in the pandemic.

Keywords:
Coronavirus Infections; Pandemics; Epilepsy; Seizures

	n, %, or mean±SD
Age (years)	45.8 (±16.2)
Educational level (years)	5.9 (±4.0)
Sex-female	56 (49.1%)
Age at epilepsy onset (years)	23 (±18.8)
Seizure frequency
≥1 seizure/month	39 (34.2%)
1-11 seizures/last year	31 (27.2%)
No seizures in the last year	44 (38.6%)
Number of AEDs taken: one	70 (61.4%)
Depression in the period before the pandemic	30 (26.3%)
Epilepsy syndrome
Genetic	6 (5.3%)
Structural	79 (69.3%)
Unknown etiology	29 (25.4%)
Subjective perception in the pandemic
Seizure frequency
Unaltered	99 (86.8%)
Increase	11 (9.6%)
Decrease	4 (3.5%)
Difficulty in obtaining AEDs	47 (41.2%)
Difficulty in contacting health professionals	34 (29.8%)
Special needs in the period
Medical support and access to AEDs	56 (49.1%)
Psychological support	25 (21.9%)
Economic, financial, and dietary problems	20 (17.5%)
Trusted information about COVID-19	15 (13.2%)

How are you feeling?	Always or part of the time	Never
Nervous	70 (61.4%)	44 (38.6%)
Hopeless	34 (29.8%)	80 (70.2%)
Tired or restless	61 (53.5%)	53 (46.5%)
Depressed - nothing can cheer me up	41 (36%)	73 (64%)
Everything is an effort	38 (33.3%)	76 (66.7%)
Useless	25 (21.9%)	89 (78.1%)
Anxiety aspects	Yes	No
Are you worried about getting the disease?	59 (51.8%)	55 (48.2%)
Are you worried about the quarantine?	37 (32.5%)	77 (67.5%)
Are you worried about interrupting your family or social life due to the lockdown?	47 (41.2%)	67 (58.8%)
Are you worried about a higher seizure frequency or severity?	46 (40.4%)	68 (59.6%)
Are you worried about financial matters?	42 (36.8%)	72 (63.2%)
Are you worried about lifestyle changes?	38 (33.3%)	76 (66.7%)
Are you worried about having to take care of other people?	33 (28.9%)	81 (71.1%)

	Worried about a higher seizure frequency or severity
	Yes (n=46)	No (n=68)	p-value
Family member with COVID-19
No	42	52	0.041*
Yes	4	16	0.041*
PWE with COVID-19
No	8	60	0.600
Yes	42	4	0.600
Seizure frequency before the pandemic
≥1 seizure/month (n=39)	21	18	0.034*
<1 seizure/month (n=75)	25	50	0.034*
	Depressed - nothing can cheer me up
	Yes (n=41)	No (n=73)	p-value
Number of AEDs taken
One	20	50	0.038*
≥2	21	23	0.038*
Depression in the period before the pandemic
No	13	60	0.006*
Yes	17	13	0.006*
	Worried about being useless
	Yes (n=25)	No (n=89)	p-value
Depression in the period before the pandemic
No	12	72	0.001*
Yes	13	17	0.001*
	Worried about lifestyle changes
	Yes (n=38)	No (n=76)	p-value
Seizure frequency before the pandemic
≥1 seizure/month (n=39)	18	21	0.036*
<1 seizure/month (n=75)	20	55	0.036*

	Increase in the number of seizures in the COVID-19 pandemic
	No (n=103)	Yes (n=11)	p-value
PWE with COVID-19
No	93	9	0.326^a
Yes	10	2	0.326^a
Epilepsy
Genetic	3	3	0.001^b*
Unknown etiology	25	4
Structural	75	4
Seizure frequency before the pandemic
≥1 seizure/month	33	6	0.182^a
<1 seizure/month	70	5	0.182^a
Depression in the period before the pandemic
No	79	5	0.036^a*
Yes	24	6	0.036^a*
Perceived nervousness in the pandemic period
No	35	9	0.003^a*
Yes	68	2	0.003^a*
Worried about a higher seizure frequency or severity
No	62	6	0.754^b
Yes	41	5	0.754^b

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[1] Correspondence: João Fernando Cloclet Pio da Silva; E-mail: joao.fcps@puccampinas.edu.br