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Epilepsy patients at increased risk of death from Covid-19

Epilepsy patients at increased risk of death from Covid-19

People with epilepsy are at increased risk of being hospitalised with and dying from Covid-19 infections compared to people without epilepsy, a new study has shown.

Researchers at the Universities of Swansea and Edinburgh found that epilepsy patients were 60 per cent more likely to be hospitalised and 33 per cent more likely to die as a result of a Covid-19 infection in the first fifteen months of the pandemic.

The findings, published as two papers in the journal Epilepsia (Paper 1 and Paper 2), could have implications for prioritising future Covid-19 treatments and vaccinations for people with epilepsy.

Epilepsy is a neurological condition causing frequent seizures, significant comorbidities and an increased risk of premature mortality. It affects approximately 50 million people worldwide and over 600,000 people in the UK. As with many treatment and healthcare provisions, the Covid-19 pandemic caused changes to standard epilepsy care in the UK. This analysis allowed the researchers to isolate epilepsy as a factor and observe the effects of Covid on people living with epilepsy in the early stages of the pandemic.

The research is based on anonymised health data of 27,279 people with epilepsy in Wales collected as part of the SAIL databank at Swansea University. The researchers looked at factors such as health status, use of GP services, hospital admissions, and causes of death between 1 March 2020 and 30 June 2021. The findings were compared against a control group of 135,000 people matched for other key criteria such as sex, age, other health conditions, socioeconomic status, and rates before the pandemic.

The study showed that amongst the epilepsy group, there were 933 (3.4 per cent) emissions to hospitals for Covid-19 and 158 (0.58 per cent) deaths. In the control population, there were 1,871 (1.4 per cent) and 370 (0.27 per cent) deaths and hospitalisations.

People with epilepsy had a 60 per cent higher chance of being hospitalised and a 33 per cent higher chance of death as a result of a Covid-19 infection than the control population.

Overall, there were fewer emergency department attendances, hospital admissions, and outpatient appointments for people with epilepsy and a reduction in the number of epilepsy diagnoses compared to the period before Covid-19.

Although all-cause deaths for people with epilepsy did not increase, there was a reduction in deaths unrelated to Covid-19 and a slight increase in deaths related explicitly to epilepsy. The analysis also shows no increase in the most severe form of seizure (status epilepticus) during the pandemic.

Dr Owen Pickrell, from the University of Cardiff, said: ‘The Covid-19 pandemic had significant effects on healthcare, and it is important to try and understand its full implications for people living with long-term conditions such as epilepsy. People with epilepsy were at higher risk of Covid hospitalisations and deaths, but it is not clear exactly why.’

Although further research is needed in this area to understand why people with epilepsy may be at an increased risk of severe Covid-19,  the researchers say it is essential to characterise the risk that people with epilepsy face for future health and care planning.

Professor Richard Chin from the University of Edinburgh, who co-led the research, added: ‘This work demonstrates the strengths of using routinely collected health data for research and working collaboratively. People with epilepsy and their doctors need to remain aware of the potential impact Covid-19 can have on people with epilepsy.’

 

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