AUTHOR=Mostacci Barbara , Licchetta Laura , Cacciavillani Carlotta , Di Vito Lidia , Ferri Lorenzo , Menghi Veronica , Stipa Carlotta , Avoni Patrizia , Provini Federica , Muccioli Lorenzo , Vignatelli Luca , Mazzoni Stefania , Tinuper Paolo , Bisulli Francesca 

TITLE=The Impact of the COVID-19 Pandemic on People With Epilepsy. An Italian Survey and a Global Perspective

JOURNAL=Frontiers in Neurology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.613719

DOI=10.3389/fneur.2020.613719

ISSN=1664-2295

ABSTRACT=<p><bold>Objectives:</bold> We explored the impact of the coronavirus disease-19 (COVID-19) emergency on the health of people with epilepsy (PwE). We also investigated their attitude toward telemedicine.</p><p><bold>Methods:</bold> The PubMed database up to September 10, 2020 was searched for questionnaire-based studies conducted in PwE during the COVID-19 emergency, and the literature retrieved was reviewed. In addition, all patients who had a telephone consultation with our center between May 7 and July 31, 2020 were invited to fill in a 57-item online questionnaire focusing on epilepsy and comorbidities, any changes in lifestyle or clinical conditions and any emergency-related problems arising during the COVID-19 emergency, and their views on telemedicine. Associations between variables were detected through <italic>X</italic><sup>2</sup> test and Fisher's exact test. Univariate and multivariate logistic regression models were used to evaluate the effects of different factors on clinical conditions.</p><p><bold>Results:</bold> Twelve studies met the literature search criteria. They showed that the rate of seizure worsening during the emergency ranged from 4 to 35% and was mainly correlated with epilepsy severity, sleep disturbances and COVID-19-related issues. Our questionnaire was filled in by 222 PwE or caregivers. One hundred (76.6%) reported unchanged clinical conditions, 25 (11.3%) an improvement, and 27 (12%) a deterioration. Reported clinical worsening was associated with a psychiatric condition and/or medication (OR = 12.59, <italic>p</italic> &lt; 0.001), sleep disorders (OR = 8.41, <italic>p</italic> = 0.001), limited access to healthcare (OR = 4.71, <italic>p</italic> = 0.016), and experiencing seizures during the emergency (OR = 4.51, <italic>p</italic> = 0.007). Telemedicine was considered acceptable by 116 subjects (52.3%).</p><p><bold>Conclusions:</bold> Most PwE did not experience a significant change in their clinical conditions during the COVID-19 emergency. However, severity of epilepsy, concomitant disability, comorbid psychiatric conditions, sleep disorders and limited access to healthcare may affect their health.</p>