EEG abnormalities and their radiographic correlates in a COVID-19 inpatient cohort

Hwang, Sean T., Hofstra University

Ballout, Ahmad A., Hofstra University, https://orcid.org/0000-0001-7408-4233

Sonti, Anup N., Hofstra University

Kapyur, Amitha, Hofstra University

Kirsch, Claudia, Hofstra University

Singh, Neeraj, Hofstra University

Markowitz, Noah, Feinstein Institute for Medical Research, https://orcid.org/0000-0001-9826-575X

Leung, Tung Ming, Feinstein Institute for Medical Research, https://orcid.org/0000-0002-4873-2732

Chong, Derek J., Hofstra University

Temes, Richard, Hofstra University

Pacia, Steven V., Hofstra University

Kuzniecky, Ruben I., Hofstra University

Najjar, Souhel, Hofstra University

shwang2@northwell.edu, aballout@northwell.edu, asonti@northwell.edu, akapyur1@pride.hofstra.edu, ckirsch@northwell.edu, nsingh24@northwell.edu, nmarkowitz@northwell.edu, tleung3@northwell.edu, dchong2@northwell.edu, rtemes@northwell.edu, spacia@northwell.edu, rkuzniecky@northwell.edu, snajjar@northwell.edu

Published Aug 25, 2021 on Dryad. https://doi.org/10.5061/dryad.gmsbcc2mp

Cite this dataset

Hwang, Sean T. et al. (2021). EEG abnormalities and their radiographic correlates in a COVID-19 inpatient cohort [Dataset]. Dryad. https://doi.org/10.5061/dryad.gmsbcc2mp

Abstract

Objective: To identify the prevalence of EEG abnormalities in patients with COVID-19 with neurologic changes, their associated neuroimaging abnormalities and rates of mortality.

Methods: A retrospective case series of 192 adult COVID-19 positive inpatients with EEG performed between March and June 2020 at 4 hospitals: 161 undergoing continuous, 24 routine, and 7 reduced-montage EEG. Study indication, epilepsy history, intubation status, administration of sedatives or antiseizure medications, metabolic abnormalities, neuroimaging pathology associated with epileptiform abnormalities, and in-hospital mortality were analyzed.

Results: EEG indications included encephalopathy (54.7%), seizure (18.2%), coma (17.2%), focal deficit (5.2%), and abnormal movements (4.6%). Epileptiform abnormalities occurred in 39.6% of patients: focal intermittent epileptiform discharges in 25.0%, lateralized periodic discharges in 6.3%, and generalized periodic discharges in 19.3%. Seizures were recorded in 8 patients, 3 with status epilepticus. Antiseizure medication administration, epilepsy history, and older age were associated with epileptiform abnormalities. Only 26.3% of patients with any epileptiform abnormality, 37.5% with electrographic seizures, and 25.7% patients with clinical seizures had known epilepsy. Background findings included generalized slowing (88.5%), focal slowing (15.6%), burst suppression (3.6%), attenuation (3.1%), and normal EEG (3.1%). Neuroimaging pathology was identified in 67.1% of patients with epileptiform abnormalities, over two-thirds acute. In-hospital mortality was 39.5% for patients with epileptiform abnormalities, 36.2% for those without. Risk factors for mortality were coma and ventilator support at time of EEG.

Significance: This article highlights the range of EEG abnormalities frequently associated with acute neuroimaging abnormalities in COVID-19. Mortality rates were high, particularly for patients in coma requiring mechanical ventilation. These findings may guide the prognosis and management of patients with COVID-19 and neurologic changes.

Methods

Retrospective chart review, Redcap.