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Meta-Analysis
. 2021 Dec:125:108437.
doi: 10.1016/j.yebeh.2021.108437. Epub 2021 Nov 15.

Epilepsy and the risk of severe coronavirus disease 2019 outcomes: A systematic review, meta-analysis, and meta-regression

Yusak Mangara Tua Siahaan  1 , Retno Jayantri Ketaren  1 , Vinson Hartoyo  1 , Timotius Ivan Hariyanto  2
Affiliations
Meta-Analysis

Epilepsy and the risk of severe coronavirus disease 2019 outcomes: A systematic review, meta-analysis, and meta-regression

Yusak Mangara Tua Siahaan et al. Epilepsy Behav. 2021 Dec.

Abstract

Background: Patients with epilepsy experience seizures, which have been reported to increase and worsen during the coronavirus disease (COVID-19) pandemic. However, the association between epilepsy and COVID-19 outcomes remains unclear. The aim of this study was to analyze whether patients with epilepsy have an increased risk of having poor COVID-19 outcomes.

Methods: We comprehensively evaluated potential articles extracted from the medRxiv, Europe PMC, and PubMed databases until June 30, 2021, using selected keywords. All published studies on epilepsy and COVID-19 were selected. We used the Review Manager 5.4 and Comprehensive Meta-Analysis 3 software for statistical analysis.

Results: Thirteen studies with 67,131 patients with COVID-19 were included in the analysis. Evaluation of the collated data revealed an association between epilepsy and increased severity of COVID-19 (OR, 1.69; 95%CI: 1.11-2.59; p = 0.010; I2 = 29%; random-effect modeling) and mortality from COVID-19 (OR, 1.71; 95%CI: 1.14-2.56; p = 0.010; I2 = 53%; random-effect modeling). The results also showed that the association between epilepsy and increased risk of developing severe COVID-19 is influenced by sex and neurodegenerative disease.

Conclusions: The findings of this study suggest that patients with epilepsy are at risk of having poor COVID-19 outcomes. Patients with epilepsy need special attention and should be prioritized for administration of the COVID-19 vaccine. Registration details: PROSPERO (CRD42021264979).

Keywords: COVID-19; Coronavirus disease 2019; Epilepsy; Neurology; Seizure.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
PRISMA diagram of the detailed process of selection of studies for inclusion in the systematic review and meta-analysis.
Fig. 2
Fig. 2
Forest plot that demonstrates the association of epilepsy with severe Covid-19 (A) and mortality (B) outcomes.
Fig. 3
Fig. 3
Bubble-plot for Meta-regression. Meta-regression analysis showed that the association between epilepsy and severe Covid-19 was affected by sex (A) and neurodegenerative disease (B), but not by age (C), hypertension (D), diabetes (E), stroke (F), and neoplasm (G).
Fig. 4
Fig. 4
Bubble-plot for Meta-regression. Meta-regression analysis showed that the association between epilepsy and mortality from Covid-19 was not affected by age (A), sex (B), hypertension (C), diabetes (D), stroke (E), neurodegenerative disease (F), nor neoplasm (G).
Fig. 5
Fig. 5
Funnel plot analysis for the association of epilepsy with severe Covid-19 (A) and mortality (B) outcomes.
See this image and copyright information in PMC

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