EEG findings and clinical prognostic factors associated with mortality in a prospective cohort of inpatients with COVID-19

Seizure. 2020 Dec:83:1-4. doi: 10.1016/j.seizure.2020.10.007. Epub 2020 Oct 13.

Abstract

Purpose: Our objective is to describe the most prevalent electroencephalographic findings in COVID-19 hospitalized patients, and to determine possible predictors of mortality including EEG and clinical variables.

Methods: A multicentric prospective observational study in patients with COVID-19 requiring EEG during hospitalization.

Results: We found 94 EEG from 62 patients (55 % men, mean age 59.7 ± 17.8 years) were analyzed. Most frequent comorbidity was cardiac (52 %), followed by metabolic (45 %) and CNS disease (39 %). Patients required ICU management by 60 %, with a mortality of 27 % in the whole cohort. The most frequent EEG finding was generalized continuous slow-wave activity (66 %). Epileptic activity was observed in 19 % including non-convulsive status epilepticus, seizures and interictal epileptiform discharges. Periodic patterns were observed in 3 patients (3.2 %). Multivariate analysis found that cancer comorbidity and requiring an EEG during the third week of evolution portended a higher risk of mortality CONCLUSION: We observed that the most prevalent EEG finding in this cohort was generalized continuous slow-wave activity, while epileptic activity was observed in less than 20 % of the cases. Mortality risk factors were comorbidity with cancer and requiring an EEG during the third week of evolution, possibly related to the hyperinflammatory state.

Keywords: COVID-19; Electroencephalogram; Mortality.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / diagnosis
  • COVID-19 / mortality*
  • COVID-19 / physiopathology
  • Electroencephalography* / methods
  • Epilepsy / physiopathology
  • Epilepsy / virology
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Inpatients
  • Male
  • Middle Aged
  • Prognosis
  • SARS-CoV-2 / pathogenicity*
  • Seizures / physiopathology*
  • Seizures / virology
  • Status Epilepticus / mortality
  • Status Epilepticus / physiopathology
  • Status Epilepticus / virology