Cross-sectional case-control studies
The objective of this cross-sectional observational study was to estimate the incidence and fatality of COVID-19 and identify potential risk factors to fatality in patients with active epilepsy.
A control group was used to compare the cumulative incidence and case fatality rate (CFR). The main outcomes of the study were cumulative incidence, defined as number of patients with active epilepsy and COVID-19 admitted to the emergency department divided by the total number of patients with epilepsy at risk; and CFR based on the number of deaths during the enrolment period. Of the 1537 patients who fulfilled inclusion criteria, 21 (1.3%) had active epilepsy. The cumulative incidence (95% CI) of COVID-19 in epilepsy patients was higher (1.2% [0.6-2.4]) compared to the population without epilepsy (0.5% [0.5-0.5]). In RT-PCR positive patients, CFR was numerically higher in patients with active epilepsy compared to patients without epilepsy, but this was not statistically significant (33.3% vs. 8.3%; p =0.266). Of the 21 active epilepsy patients, 5 (23%) died. In multivariate analysis, the main factor associated with fatality in patients with active epilepsy was hypertension (OR [95%CI], 2.8 [1.3-21.6]). In other models, age (OR [95%CI], 1.0 [1.0-1.1]) and epilepsy (OR [95%CI], 5.1 [1.3-24.0]) were associated with fatality during hospitalisation. The authors concluded that COVID-19 cumulative incidence was higher in patients with active epilepsy. Hypertension was associated with fatality in patients with epilepsy.