Incidence and Outcomes of COVID-19 in US Veterans with Epilepsy (VWE) with or Without Comorbid Obstructive Sleep Apnea (OSA): A Two-year Review
Abstract number :
3.405
Submission category :
16. Epidemiology
Year :
2022
Submission ID :
2204434
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:25 AM
Authors :
Vikas Singh, MD, MHSA, FAES – Kansas City VA Medical Center; Varun Chandra Boinpelly, MS – Kansas City VA Medical Center; Muhtadi Islam, MD, PhD – Neurology – University of Kansas Medical Center; Yana Vaysberg, MD – Neurology – Kansas City VA Medical Center; Mariana Garcia-Touza, MD – Endocrinology – Kansas City VA Medical Center; Rishi Sharma, MD – Internal Medicine – University of Missouri, Kansas City; Dana Hawkinson, MD – Infectious Disease – University of Kansas Medical Center; Ram Sharma, PhD, MHSA – Kansas City VA Medical Center; Mukut Sharma, PhD – Kansas City VA Medical Center; Thomas Wiegmann, MD – Nephrology – Kansas City VA Medical Center
Rationale: The coronavirus disease 2019 (COVID-19) pandemic has globally affected public health and the health care delivery systems. The significance and contribution of preexisting epilepsy with or without OSA is not known. This retrospective database study was performed to determine the prevalence, associated risk factors and outcomes in COVID positive VWE.
Methods: We utilized Veterans Affairs COVID-19 resource data to examine the role of epilepsy with or without OSA on incidence of COVID and overall morbidity associated with it. The database combines data from disparate VA and non-VA sources and includes hospital data, administrative and clinical records. ICD codes were used to identify clinical conditions of interest and were considered present if they occurred at any time within the 2 years prior to the COVID test (prevalence, pre-condition), while new results (incidence) refer to 60-day period after. We examined the effects of demographic factors as well as presence or absence of prior epilepsy and OSA (pre-condition) on incidence of COVID, hospital admission, ICU admission, ventilator use, ventilator associated pneumonia, oxygen use, emergency department visits, 30-day readmission rate, length of stays and all-cause mortality during 60-day post-COVID diagnosis (Figure 1, study schema). Statistical analysis (SAS enterprise guide 7.1) used frequency distributions (chi square) and odds ratios.
Results: The study population consisted of 1,994 533 veterans who had COVID testing done, 557,208 tested positive (Pos, 27.9%), Alpha (44.5%), Delta (21.5%), Omicron (34%). There were total of 31056 VWE in the cohort with 8707 tested positive and 22349 tested negative with the COVID positivity rate across entire cohort being 1.6%. The entire cohort was predominantly white male over 60 years of age (Table 1). There was no significant difference in COVID positivity rate amongst VWE with or without OSA. The incidence of epilepsy post-COVID diagnosis were similar to the reported rate across general population (Table 2). There was no significant difference between two groups of VWE with and without OSA for outcome variables including mortality, hospital admission and average length of stay (LOS), ICU admission and LOS, ventilator use and average number of days of ventilator use, and total acute care LOS (Table 3).
Conclusions: Preexisting epilepsy with or without OSA in veterans does not have any significant impact on COVID positivity rates. VWE with or without OSA who acquire COVID do not appear to differ significantly with regards to morbidity and mortality. The rates of post-COVID epilepsy appear to be similar to that in general population without COVID. Further studies with propensity matching for confounding variables are under way.
Funding: Midwest Veterans Biomedical Research Foundation, Kansas City VA Medical Center
Epidemiology