Seizures Linked With Higher Mortality in COVID-19 Patients

To date, there have been only a few small reports of seizures in patients with severe COVID-19 and the effects them on patients' health was previously unknown.

A recent study published in the journal Annals of Neurology has found that some patients who are hospitalized with COVID-19 can experience non-convulsive seizures, which can increase their risk of death. The study was conducted by investigators from Massachusetts General Hospital (MGH) and Beth Israel Deaconess Medical Center (BIDMC).

"Seizures are a very common complication of severe critical illness. Most of these seizures are not obvious: Unlike seizures that make a person fall down and shake, or convulse, seizures in critically ill patients are usually nonconvulsive," M. Brandon Westover, co-senior author on the study said. "There is increasing evidence that non-convulsive seizures can damage the brain and make outcomes worse, similar to convulsions."

For the study, the investigators analyzed 197 hospitalized COVID-19 patients medical records who underwent electroencephalogram (EEG) monitoring at 9 institutions in North America and Europe.

Findings from the study showed that the EEG tests detected non-convulsive seizures in 9.6% of the patients. Those who did experience the seizures needed to be in the hospital for a longer period of time and were also 4 times more likely to die in the hospital in comparison to those who did not have any seizures.

Many of the patients who experienced the seizures had no prior neurological issues before their illness with COVID-19. The findings suggest that the disease can cause neurological complications that can contribute to the mortality that is associated with the virus.

"We found that seizures indeed can happen in patients with COVID-19 critical illness, even those without any prior neurologic history, and that they are associated with worse outcomes: higher rates of death and longer hospital stay, even after adjusting for other factors," Mouhsin Shafi, co-senior author on the study said. "Our results suggest that patients with COVID-19 should be monitored closely for nonconvulsive seizures. Treatments are available and warranted in patients at high risk; however, further research is needed to clarify how aggressively to treat seizures in COVID-19."