Electroencephalographic findings among inpatients with COVID-19 in a tertiary hospital from a middle-income country

ABSTRACT Background: In 2019, the world witnessed the emergence of a new type of coronavirus - the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The spectrum of coronavirus disease 2019 (COVID-19) is variable, and amongst its manifestations are neurological implications. Objective: This report aimed to describe electroencephalographic findings in COVID-19 patients from a general tertiary hospital in São Paulo, Brazil. Methods: It was a retrospective, observational, and non-interventional study. Data were collected anonymously, comprising inpatients from Mar 1 to Jun 30, 2020, either confirmed (positive RT-PCR) or probable cases (CO-RADS 4/5) who had performed EEG during hospitalization. Results: Twenty-eight patients were enrolled, 17 (60.7%) women and 11 men, with a median age of 58 (minimum and maximum: 18-86; IQR 23.5). COVID-19 diagnosis was confirmed in 22 (78.5%). Twenty-one patients (75%) had severe disease, requiring mechanical ventilation due to acute respiratory distress syndrome (ARDS); 16 (57.1%) patients developed adjunct sepsis throughout hospitalization. There was no specific pattern found for COVID-19 in EEG. No patients presented with status epilepticus or electrographic events; most patients developed an encephalopathic pattern, as seen in most studies, with a high prevalence of altered mental status as an indication for EEG. Adjunct sepsis was associated with higher mortality. Conclusions: EEG presents as a useful tool in the context of COVID-19, as in other conditions, to differentiate nonconvulsive status epilepticus (NCSE) from encephalopathy and other causes of mental status alterations. Further studies are required to analyze whether there might be a specific EEG pattern to the disease.

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Main Authors: CORAZZA,Luíza Alves, TATSCH,João Fellipe Santos, BARROS,Maraysa Pereira, QUEIROZ,Apolônio Peixoto de, BATISTA,Luana Lôbo Ribeiro, AIDAR,Mariana Barbosa, BALDOCCHI,Meire Argentoni, ROCHA,Maria Sheila Guimarães, BRUCKI,Sonia Maria Dozzi
Format: Digital revista
Language:English
Published: Academia Brasileira de Neurologia - ABNEURO 2021
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000400315
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spelling oai:scielo:S0004-282X20210004003152021-06-07Electroencephalographic findings among inpatients with COVID-19 in a tertiary hospital from a middle-income countryCORAZZA,Luíza AlvesTATSCH,João Fellipe SantosBARROS,Maraysa PereiraQUEIROZ,Apolônio Peixoto deBATISTA,Luana Lôbo RibeiroAIDAR,Mariana BarbosaBALDOCCHI,Meire ArgentoniROCHA,Maria Sheila GuimarãesBRUCKI,Sonia Maria Dozzi Electroencephalography Betacoronavirus Encephalopathy Status Epilepticus ABSTRACT Background: In 2019, the world witnessed the emergence of a new type of coronavirus - the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The spectrum of coronavirus disease 2019 (COVID-19) is variable, and amongst its manifestations are neurological implications. Objective: This report aimed to describe electroencephalographic findings in COVID-19 patients from a general tertiary hospital in São Paulo, Brazil. Methods: It was a retrospective, observational, and non-interventional study. Data were collected anonymously, comprising inpatients from Mar 1 to Jun 30, 2020, either confirmed (positive RT-PCR) or probable cases (CO-RADS 4/5) who had performed EEG during hospitalization. Results: Twenty-eight patients were enrolled, 17 (60.7%) women and 11 men, with a median age of 58 (minimum and maximum: 18-86; IQR 23.5). COVID-19 diagnosis was confirmed in 22 (78.5%). Twenty-one patients (75%) had severe disease, requiring mechanical ventilation due to acute respiratory distress syndrome (ARDS); 16 (57.1%) patients developed adjunct sepsis throughout hospitalization. There was no specific pattern found for COVID-19 in EEG. No patients presented with status epilepticus or electrographic events; most patients developed an encephalopathic pattern, as seen in most studies, with a high prevalence of altered mental status as an indication for EEG. Adjunct sepsis was associated with higher mortality. Conclusions: EEG presents as a useful tool in the context of COVID-19, as in other conditions, to differentiate nonconvulsive status epilepticus (NCSE) from encephalopathy and other causes of mental status alterations. Further studies are required to analyze whether there might be a specific EEG pattern to the disease.info:eu-repo/semantics/openAccessAcademia Brasileira de Neurologia - ABNEUROArquivos de Neuro-Psiquiatria v.79 n.4 20212021-04-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000400315en10.1590/0004-282x-anp-2020-0555
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libraryname SciELO
language English
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author CORAZZA,Luíza Alves
TATSCH,João Fellipe Santos
BARROS,Maraysa Pereira
QUEIROZ,Apolônio Peixoto de
BATISTA,Luana Lôbo Ribeiro
AIDAR,Mariana Barbosa
BALDOCCHI,Meire Argentoni
ROCHA,Maria Sheila Guimarães
BRUCKI,Sonia Maria Dozzi
spellingShingle CORAZZA,Luíza Alves
TATSCH,João Fellipe Santos
BARROS,Maraysa Pereira
QUEIROZ,Apolônio Peixoto de
BATISTA,Luana Lôbo Ribeiro
AIDAR,Mariana Barbosa
BALDOCCHI,Meire Argentoni
ROCHA,Maria Sheila Guimarães
BRUCKI,Sonia Maria Dozzi
Electroencephalographic findings among inpatients with COVID-19 in a tertiary hospital from a middle-income country
author_facet CORAZZA,Luíza Alves
TATSCH,João Fellipe Santos
BARROS,Maraysa Pereira
QUEIROZ,Apolônio Peixoto de
BATISTA,Luana Lôbo Ribeiro
AIDAR,Mariana Barbosa
BALDOCCHI,Meire Argentoni
ROCHA,Maria Sheila Guimarães
BRUCKI,Sonia Maria Dozzi
author_sort CORAZZA,Luíza Alves
title Electroencephalographic findings among inpatients with COVID-19 in a tertiary hospital from a middle-income country
title_short Electroencephalographic findings among inpatients with COVID-19 in a tertiary hospital from a middle-income country
title_full Electroencephalographic findings among inpatients with COVID-19 in a tertiary hospital from a middle-income country
title_fullStr Electroencephalographic findings among inpatients with COVID-19 in a tertiary hospital from a middle-income country
title_full_unstemmed Electroencephalographic findings among inpatients with COVID-19 in a tertiary hospital from a middle-income country
title_sort electroencephalographic findings among inpatients with covid-19 in a tertiary hospital from a middle-income country
description ABSTRACT Background: In 2019, the world witnessed the emergence of a new type of coronavirus - the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The spectrum of coronavirus disease 2019 (COVID-19) is variable, and amongst its manifestations are neurological implications. Objective: This report aimed to describe electroencephalographic findings in COVID-19 patients from a general tertiary hospital in São Paulo, Brazil. Methods: It was a retrospective, observational, and non-interventional study. Data were collected anonymously, comprising inpatients from Mar 1 to Jun 30, 2020, either confirmed (positive RT-PCR) or probable cases (CO-RADS 4/5) who had performed EEG during hospitalization. Results: Twenty-eight patients were enrolled, 17 (60.7%) women and 11 men, with a median age of 58 (minimum and maximum: 18-86; IQR 23.5). COVID-19 diagnosis was confirmed in 22 (78.5%). Twenty-one patients (75%) had severe disease, requiring mechanical ventilation due to acute respiratory distress syndrome (ARDS); 16 (57.1%) patients developed adjunct sepsis throughout hospitalization. There was no specific pattern found for COVID-19 in EEG. No patients presented with status epilepticus or electrographic events; most patients developed an encephalopathic pattern, as seen in most studies, with a high prevalence of altered mental status as an indication for EEG. Adjunct sepsis was associated with higher mortality. Conclusions: EEG presents as a useful tool in the context of COVID-19, as in other conditions, to differentiate nonconvulsive status epilepticus (NCSE) from encephalopathy and other causes of mental status alterations. Further studies are required to analyze whether there might be a specific EEG pattern to the disease.
publisher Academia Brasileira de Neurologia - ABNEURO
publishDate 2021
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000400315
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