Epilepsy and COVID-19: is infection related to an increased risk of seizure recurrence?

Abstract

Background. Over the two last years the novel coronavirus infection, COronaVIrus Disease 2019 (COVID-19), has become one of the urgent health and social problems. Reports on the SARS-CoV-2 neuroinvasiveness raise the question as to whether the infection could be related to an increased risk of seizure recurrence in patients with concomitant epilepsy and COVID-19.Objective: to study the seizure dynamics in patients with epilepsy recovered after COVID-19 by analyzing clinical observations.Material and methods. A single-center retrospective uncontrolled open-label observational study regarding an impact of COVID-19 on the course of epilepsy was performed. Patients with epilepsy recovered after COVID-19 were interviewed between January and February 2021 by using a questionnaire containing three sets of questions. The study included 13 patients suffering from COVID-19 along with epilepsy: 7 cases (54%) of genetic (idiopathic) generalised form, 6 cases (46%) of focal form. The mean age was 34.31±12.68 years.Results. Seizure remission prior to COVID-19 was noted in 10 patients (77%), with no seizure control found in 3 cases (23%) of focal epilepsy at the time of COVID-19. No seizure frequency rise was observed in any case. No recurrent seizures were detected. Electroencephalographic follow-up showed no exacerbated seizures compared to the pre-infection parameters. Monotherapy with anti-epileptic drugs was used in 61% of cases. Levetiracetam monotherapy was administered to 50% of patients, and as a part of a polytherapy regimen – to 100%.Conclusion. The research findings and literature data show that patients with epilepsy are not at greater risk than the general population. Young age, seizure remission, absence of somatic comorbidities, modern drug use with no interaction with antibiotics and antivirals for the coronavirus disease treatment can be considered as positive predictive value of the course of epilepsy with COVID-19. Further studies are required to be performed in a larger patient sample.