Electroencephalography at the height of a pandemic: EEG findings in patients with COVID-19.

Link: https://doi.org/S1388-2457(22)00190-0
Authors: Tantillo, Gabriela B; Jetté, Nathalie; Gururangan, Kapil; Agarwal, Parul; Marcuse, Lara; Singh, Anuradha; Goldstein, Jonathan; Kwon, Churl-Su; Dhamoon, Mandip S; Navis, Allison; Nadkarni, Girish N; Charney, Alexander W; Young, James J; Blank, Leah J; Fields, Madeline; Yoo, Ji Yeoun

Abstract: To characterize continuous video electroencephalogram (VEEG) findings of hospitalized COVID-19 patients. We performed a retrospective chart review of patients admitted at three New York City hospitals who underwent VEEG at the peak of the COVID-19 pandemic. Demographics, comorbidities, neuroimaging, VEEG indications and findings, treatment, and outcomes were collected. Of 93 patients monitored, 77% had severe COVID-19 and 40% died. Acute ischemic or hemorrhagic stroke was present in 26% and 15%, respectively. Most common VEEG indications were encephalopathy/coma (60%) and seizure-like movements (38%). Most common VEEG findings were generalized slowing (97%), generalized attenuation (31%), generalized periodic discharges (17%) and generalized sharp waves (15%). Epileptiform abnormalities were present in 43% and seizures in 8% of patients, all of whom had seizure risk factors. Factors associated with an epileptiform VEEG included increasing age (OR 1.07, p = 0.001) and hepatic/renal failure (OR 2.99, p = 0.03). Most COVID-19 patients who underwent VEEG monitoring had severe COVID-19 and over one-third had acute cerebral injury (e.g., stroke, anoxia). Seizures were uncommon. VEEG findings were nonspecific. VEEG findings in this cohort of hospitalized COVID-19 patients were those often seen in critical illness. Seizures were uncommon and occurred in the setting of common seizure risk factors.