Study: Older COVID-19 patients with epilepsy, multimorbidity highly vulnerable

Factors such as older age (>65 years), ventilator use, and higher comorbidity all contribute to increased mortality risk with COVID-19 among patients with epilepsy, as reported in a study.

Researchers conducted a retrospective study involving 9,833 patients with COVID-19 admitted in a multicentre health system. Of these, 334 had epilepsy. Logistic regression models and Kaplan-Meier analyses were used to examine outcomes such as mortality and nonroutine discharges (ie, not discharged home). An ordinary least squares regression model was fitted for length-of-stay (LOS).

In univariate analysis, COVID-19 patients with vs without epilepsy were more likely to have higher ventilator use (37.70 percent vs 14.30 percent; p<0.001), ICU admissions (39.20 percent vs 17.70 percent; p<0.001), mortality (29.60 percent vs 19.90 percent; p<0.001), longer LOS (12 vs 7 days; p<0.001), and less likely to be discharged home (29.64 percent vs 57.37 percent; p<0.001) in univariable analysis.

When adjustments were made of potential confounders, COVID-19 patients with vs without epilepsy differed only in terms of nonroutine discharge (adjusted odds ratio [aOR], 2.70, 95 percent confidence interval [CI], 2.00–3.70; p<0.001) and LOS (32.50 percent longer, 95 percent CI, 22.20–43.60; p<0.001).

The odds of mortality among COVID-19 patients with epilepsy were positively associated with older age (aOR, 1.05, 95 percent CI, 1.03–1.08; p<0.001), ventilator support (aOR, 7.18, 95 percent CI, 3.12–16.48; p<0.001), and higher Charlson Comorbidity Index (CCI; aOR, 1.18, 95 percent CI, 1.04–1.34; p=0.010).

The findings underscore the importance of close monitoring of older adults with epilepsy and multimorbidity in the setting of COVID-19.