This is a Late Breaking abstractRationale: Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, manifests predominantly with respiratory symptoms, though a significant number of patients suffer from neurological complications, including toxic-metabolic encephalopathy, hypoxic-ischemic brain injury, strokes, seizures, Guillain-Barré Syndrome, and prolonged cognitive impairment.
1 There are emerging data that infection with SARS-CoV-2 causes dysregulation of the immune system and may lead to autoimmune phenomena, including neurological autoimmune diseases, such as autoimmune encephalitis (AE) with seizures.
2 In this context, we evaluated if there was an increase in hospital admissions of patients with AE diagnosis since the onset of COVID-19 pandemic in our region.
Methods: We queried the database of patients seen at the Loma Linda University Medical Center, which is a tertiary medical center in San Bernardino County in Southern California, using Slicer Dicer – a search tool integrated within EPIC electronic medical record system. The search criteria were hospital admissions during the period of 10/01/2015 until 09/12/2022, for patients who had the diagnosis of AE, that was not chronic. We sorted the number of patient admissions fulfilling the above criteria per quarter periods. We analyzed if there is a difference in the number of patients admitted to the hospital with the diagnosis of AE before and after the onset of COVID-19 pandemic, with the onset of pandemic being the first quarter of 2020, using Unpaired t-test.
Results: The sum of all admitted patients with the diagnosis of AE per quarter period was 212. There was a total of 107 patients during quarter periods between 10/01/2015 and 12/31/2019, and a total of 105 patients during quarter periods between 01/01/2020 and 09/12/2022, indicating that the number of patients admitted with the diagnosis of AE since the onset of the COVID-19 pandemic was almost the same as the number of patients in the four-year period prior to the onset of the pandemic (Figure 1). When comparing the two groups using Unpaired t-test, the P value was 0.0068, which is statistically very significant. Notably, the peak numbers of admitted patients with the diagnosis of AE correlated with the peak numbers of COVID-19 cases in our region (Figure 2).
3Conclusions: There was a statistically significant increase in the number of admitted patients with the diagnosis of AE per quarter period during COVID-19 era in our region, compared to the four years prior. Though there is no causation that can be inferred based on this analysis, our results warrant further study of relationship between the COVID-19 pandemic and AE.
References:
1. Dalmau J, Dalakas MC, Kolson DL, Paul F, Zamvil SS. N2 year in review. Neurol Neuroimmunol Neuroinflamm. 2020;8(1):e925.
2. Valencia Sanchez C, Theel E, Binnicker M, Toledano M, McKeon A. Autoimmune Encephalitis After SARS-CoV-2 Infection: case frequency, findings, and outcomes. Neurology. 2021;97(23):e2262-e2268.
3. CDC. (2022). COVID Data Tracker.
https://covid.cdc.gov/covid-data-tracker/Funding: None