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In-hospital outcomes in patients with and without epilepsy diagnosed with COVID-19-A cohort study.
Ufongene, Claire; Van Hyfte, Grace; Agarwal, Parul; Blank, Leah J; Goldstein, Jonathan; Mathew, Brian; Lin, Jung-Yi; Navis, Allison; McCarthy, Louise; Gururangan, Kapil; Peschansky, Veronica; Kwon, Churl-Su; Cohen, Ariella; Chan, Andy Ho Wing; Dhamoon, Mandip; Deng, Pojen; Gutzwiller, Eveline M; Hao, Qing; He, Celestine; Heredia Nunez, Wilson D; Klenofsky, Britany; Lemus, Hernan Nicolas; Marcuse, Lara; Roberts, Mallory; Schorr, Emily M; Singh, Anuradha; Tantillo, Gabriela; Young, James; Balchandani, Priti; Festa, Joanne; Naasan, Georges; Charney, Alexander; Nadkarni, Girish; Jetté, Nathalie.
Afiliação
  • Ufongene C; Icahn School of Medicine at Mount Sinai (ISMMS), New York, New York, USA.
  • Van Hyfte G; Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, New York, USA.
  • Agarwal P; Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, New York, USA.
  • Blank LJ; Department of Neurology, ISMMS, New York, New York, USA.
  • Goldstein J; Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, New York, USA.
  • Mathew B; Department of Neurology, ISMMS, New York, New York, USA.
  • Lin JY; Icahn School of Medicine at Mount Sinai (ISMMS), New York, New York, USA.
  • Navis A; Department of Neurology, ISMMS, New York, New York, USA.
  • McCarthy L; Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, New York, USA.
  • Gururangan K; Department of Neurology, ISMMS, New York, New York, USA.
  • Peschansky V; Department of Neurology, ISMMS, New York, New York, USA.
  • Kwon CS; Department of Neurology, ISMMS, New York, New York, USA.
  • Cohen A; Department of Neurology, ISMMS, New York, New York, USA.
  • Chan AHW; Department of Neurology, Columbia University, New York, New York, USA.
  • Dhamoon M; Department of Neurology, Columbia University, New York, New York, USA.
  • Deng P; Department of Neurosurgery, Epidemiology, and the Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA.
  • Gutzwiller EM; Icahn School of Medicine at Mount Sinai (ISMMS), New York, New York, USA.
  • Hao Q; Department of Neurology, ISMMS, New York, New York, USA.
  • He C; Department of Neurology, ISMMS, New York, New York, USA.
  • Heredia Nunez WD; Department of Neurology, ISMMS, New York, New York, USA.
  • Klenofsky B; Department of Neurology, ISMMS, New York, New York, USA.
  • Lemus HN; Department of Neurology, ISMMS, New York, New York, USA.
  • Marcuse L; Icahn School of Medicine at Mount Sinai (ISMMS), New York, New York, USA.
  • Roberts M; Department of Neurology, ISMMS, New York, New York, USA.
  • Schorr EM; Department of Neurology, ISMMS, New York, New York, USA.
  • Singh A; Epilepsy Department, Brigham and Women's Hospital, Boston, Massachusetts, USA.
  • Tantillo G; Department of Neurology, ISMMS, New York, New York, USA.
  • Young J; Department of Neurology, ISMMS, New York, New York, USA.
  • Balchandani P; Division of Neuroimmunology and Neuroinfectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Festa J; Department of Neurology, ISMMS, New York, New York, USA.
  • Naasan G; Department of Neurology, Baylor College of Medicine, Houston, Texas, USA.
  • Charney A; Department of Neurology, ISMMS, New York, New York, USA.
  • Nadkarni G; BioMedical Engineering and Imaging Institute, ISMMS, New York, New York, USA.
  • Jetté N; Department of Neurology, ISMMS, New York, New York, USA.
Epilepsia ; 64(10): 2725-2737, 2023 Oct.
Article em En | MEDLINE | ID: mdl-37452760
OBJECTIVES: Coronavirus disease 2019 (COVID-19) is associated with mortality in persons with comorbidities. The aim of this study was to evaluate in-hospital outcomes in patients with COVID-19 with and without epilepsy. METHODS: We conducted a retrospective study of patients with COVID-19 admitted to a multicenter health system between March 15, 2020, and May 17, 2021. Patients with epilepsy were identified using a validated International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)/ICD-10-CM case definition. Logistic regression models and Kaplan-Meier analyses were conducted for mortality and non-routine discharges (i.e., not discharged home). An ordinary least-squares regression model was fitted for length of stay (LOS). RESULTS: We identified 9833 people with COVID-19 including 334 with epilepsy. On univariate analysis, people with epilepsy had significantly higher ventilator use (37.70% vs 14.30%, p < .001), intensive care unit (ICU) admissions (39.20% vs 17.70%, p < .001) mortality rate (29.60% vs 19.90%, p < .001), and longer LOS (12 days vs 7 days, p < .001). and fewer were discharged home (29.64% vs 57.37%, p < .001). On multivariate analysis, only non-routine discharge (adjusted odds ratio [aOR] 2.70, 95% confidence interval [CI] 2.00-3.70; p < .001) and LOS (32.50% longer, 95% CI 22.20%-43.60%; p < .001) were significantly different. Factors associated with higher odds of mortality in epilepsy were older age (aOR 1.05, 95% CI 1.03-1.08; p < .001), ventilator support (aOR 7.18, 95% CI 3.12-16.48; p < .001), and higher Charlson comorbidity index (CCI) (aOR 1.18, 95% CI 1.04-1.34; p = .010). In epilepsy, admissions between August and December 2020 or January and May 2021 were associated with a lower odds of non-routine discharge and decreased LOS compared to admissions between March and July 2020, but this difference was not statistically significant. SIGNIFICANCE: People with COVID-19 who had epilepsy had a higher odds of non-routine discharge and longer LOS but not higher mortality. Older age (≥65), ventilator use, and higher CCI were associated with COVID-19 mortality in epilepsy. This suggests that older adults with epilepsy and multimorbidity are more vulnerable than those without and should be monitored closely in the setting of COVID-19.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Epilepsia / COVID-19 Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Epilepsia / COVID-19 Idioma: En Ano de publicação: 2023 Tipo de documento: Article