EEG Findings and Clinical Outcome in Hospitalized COVID-19 Patients with Acute Encephalopathy: A Large Healthcare System Retrospective Cohort Study
Abstract number :
2.013
Submission category :
3. Neurophysiology / 3B. ICU EEG
Year :
2021
Submission ID :
1825972
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:51 AM
Authors :
Tian Wang, MD - Georgetown University School of Medicine/JHU SOM; Katelynn Getchell - Georgetown University School of Medicine, Washington DC; Shahnaz Miri - Department of Neuro-ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami FL and Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD; Amy Safadi - Department of Neurology, Georgetown University Hospital; Nassim Zecaveti - Department of Pediatric Neurology, VCU Health; Gholam Motamedi - Department of Neurology, Georgetown University Hospital, Washington DC
Rationale: COVID-19 patients may present with CNS involvement and a variety of neurological manifestations. There are no predictable markers for clinical outcome of patients presenting with acute mental status change. This study aimed to evaluate the clinical features including EEG findings, neuroimage results, hospital course and outcome in COVID-19 patients presenting with acute encephalopathy.
Methods: This is a retrospective multicenter study, approved by institutional review board at MedStar Health. All patients admitted with a confirmed diagnosis of COVID-19 with a positive high-throughput sequencing or real-time reverse-transcription polymerase chain reaction analysis will be included. Electronic medical records for these patients admitted from April 2020 to July 2020 were reviewed and those with EEG and neurological examination were including in this study. Statistical analysis was performed using SPSS 25.
Results: Total 22 patients (10 female, 12 male) admitted with COVID-19, who had EEG study for evaluation of acute mental status change, were enrolled in this study. Mean age of these patients was 57.8 +/- 13.3 (26-83) years. 59.1% were African American, 22.7% Hispanic. Mean WBC count was 7.9 +/- 3.1. ESR and CRP levels were elevated in all patients (mean ESR 76.3 +/-14.9, and CRP 129.5 +/-70). Six patients (26.3%) had known history of epilepsy of which 4 patients had breakthrough seizure during this admission. Clinical evaluation revealed metabolic abnormalities in 81.8% patients, acute ischemic stroke (4.5%), acute hemorrhagic stroke (4.5%), encephalitis (4.5%), and new onset seizure (9%). Eighteen patients (81.8%) were admitted in ICU, and 14 patients (63.6%) were intubated, and 7 patients (31.8%) were expired during this admission. Out of the EEG findings, 2 patients had interictal abnormalities including generalized periodic discharges and focal spikes. The rest all had slow background activity ranging from mild to severe. 7 patients had moderate to severe background slowing. In terms of clinical outcome, 7 patients improved back to baseline, 8 patients had residual neurological deficits and 7 patients expired during the hospital stay. Interestingly, all patients (n=7) improved back to baseline had mild background slowing, and all expired patients (n=7) had severe background slowing, which may indicate background change may be a marker of clinical outcome for COVID-19 related encephalopathy.
Conclusions: Acute alteration in mental status and severe background slowing in EEG are suggestive of ICU admission and poor outcome in hospitalized patients COVID-19.
Funding: Please list any funding that was received in support of this abstract.: There was no funding received in support of this abstract.
Neurophysiology