Epilepsy mortality in Wales during COVID-19

Daniels, Helen; Lacey, Arron; Mikadze, David; Akbari, Ashley; Fonferko-Shadrach, Beata; Hollinghurst, Joe; Lyons, Ronan; Rees, Mark; Sawhney, Inder; Powell, Robert; Kerr, Michael; Pickrell, Owen

doi:10.1016/j.seizure.2021.11.017

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Epilepsy mortality in Wales during COVID-19

Helen Daniels

, Arron Lacey, David Mikadze, Ashley Akbari

, Beata Fonferko-Shadrach, Joe Hollinghurst, Ronan Lyons

, Mark Rees, Inder Sawhney, Robert Powell, Michael Kerr, Owen Pickrell

Seizure - European Journal of Epilepsy, Volume: 94, Pages: 39 - 42

Swansea University Authors: Helen Daniels , Arron Lacey, Ashley Akbari , Beata Fonferko-Shadrach, Joe Hollinghurst, Ronan Lyons , Mark Rees, Inder Sawhney, Robert Powell, Michael Kerr, Owen Pickrell

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DOI (Published version): 10.1016/j.seizure.2021.11.017

Abstract

Purpose: The COVID-19 pandemic has increased mortality worldwide and those with chronic conditions may have been disproportionally affected. However, it is unknown whether the pandemic has changed mortality rates for people with epilepsy. We aimed to compare mortality rates in people with epilepsy i...

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Published in:	Seizure - European Journal of Epilepsy
ISSN:	1059-1311
Published:	Elsevier BV 2022
Online Access:	Check full text
URI:	https://cronfa.swan.ac.uk/Record/cronfa58860
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first_indexed	2021-12-01T14:15:14Z
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However, it is unknown whether the pandemic has changed mortality rates for people with epilepsy. We aimed to compare mortality rates in people with epilepsy in Wales during the pandemic with pre-pandemic rates. Methods: We performed a retrospective study using individual-level linked population-scale anonymised electronic health records. We identified deaths in people with epilepsy (DPWE), i.e. those with a diagnosis of epilepsy, and deaths associated with epilepsy (DAE), where epilepsy was recorded as a cause of death on death certificates. We compared death rates in 2020 with average rates in 2015–2019 using Poisson models to calculate death rate ratios. Results: There were 188 DAE and 628 DPWE in Wales in 2020 (death rates: 7.7/100,000/year and 25.7/100,000/year). The average rates for DAE and DPWE from 2015 to 2019 were 5.8/100,000/year and 23.8/100,000/year, respectively. Death rate ratios (2020 compared to 2015–2019) for DAE were 1.34 (95%CI 1.14–1.57, p<0.001) and for DPWE were 1.08 (0.99–1.17, p = 0.09). The death rate ratios for non-COVID deaths (deaths without COVID mentioned on death certificates) for DAE were 1.17 (0.99–1.39, p = 0.06) and for DPWE were 0.96 (0.87–1.05, p = 0.37). Conclusions: The significant increase in DAE in Wales during 2020 could be explained by the direct effect of COVID-19 infection. Non-COVID-19 deaths have not increased significantly but further work is needed to assess the longer-term impact.</abstract><type>Journal Article</type><journal>Seizure - European Journal of Epilepsy</journal><volume>94</volume><journalNumber/><paginationStart>39</paginationStart><paginationEnd>42</paginationEnd><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>1059-1311</issnPrint><issnElectronic/><keywords>Data linkage, electronic health records, pandemic, COVID-19</keywords><publishedDay>1</publishedDay><publishedMonth>1</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-01-01</publishedDate><doi>10.1016/j.seizure.2021.11.017</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm>External research funder(s) paid the OA fee (includes OA grants disbursed by the Library)</apcterm><funders>This work was supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust . JH was supported by Health and Care research Wales [Project: SCF-18-1504 ]. AA, JH and RL were supported by the con-cov grant funded by the Medical Research Council (Grant No. MR/V028367/1 ), ADR Wales programme of work funded by the ADR UK (Grant ES/S007393/1 ) and the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales. This work was supported by staff funded as part of the Brain Repair and Intracranial Neurotherapeutics (BRAIN) Unit and the Wales Gene Park, infrastructure support groups funded by Welsh Government through Health and Care Research Wales. This study makes use of anonymised data held in the Secure Anonymised Information Linkage (SAIL) Databank. We would like to acknowledge all the data providers who make anonymised data available for research. Approval for the use of data in this study, within the SAIL Databank, was granted by an independent information governance review panel (project 0696).</funders><projectreference/><lastEdited>2022-08-16T12:47:53.6969383</lastEdited><Created>2021-12-01T14:09:55.1813543</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Helen</firstname><surname>Daniels</surname><orcid>0000-0001-8899-0333</orcid><order>1</order></author><author><firstname>Arron</firstname><surname>Lacey</surname><order>2</order></author><author><firstname>David</firstname><surname>Mikadze</surname><order>3</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>4</order></author><author><firstname>Beata</firstname><surname>Fonferko-Shadrach</surname><order>5</order></author><author><firstname>Joe</firstname><surname>Hollinghurst</surname><order>6</order></author><author><firstname>Ronan</firstname><surname>Lyons</surname><orcid>0000-0001-5225-000X</orcid><order>7</order></author><author><firstname>Mark</firstname><surname>Rees</surname><orcid/><order>8</order></author><author><firstname>Inder</firstname><surname>Sawhney</surname><order>9</order></author><author><firstname>Robert</firstname><surname>Powell</surname><order>10</order></author><author><firstname>Michael</firstname><surname>Kerr</surname><order>11</order></author><author><firstname>Owen</firstname><surname>Pickrell</surname><orcid>0000-0003-4396-5657</orcid><order>12</order></author></authors><documents><document><filename>58860__21860__0a1c5cf4f4b84a2aac3305ba672b92b5.pdf</filename><originalFilename>58860.APCH054.VOR.pdf</originalFilename><uploaded>2021-12-09T13:46:09.7287345</uploaded><type>Output</type><contentLength>943038</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>Copyright: The Authors. 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spelling	2022-08-16T12:47:53.6969383 v2 58860 2021-12-01 Epilepsy mortality in Wales during COVID-19 a054902cb884be2476d0f097f0016294 0000-0001-8899-0333 Helen Daniels Helen Daniels true false b69d245574e754d2637cc9e76379fe11 Arron Lacey Arron Lacey true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 7d3f1e80939f2b8fab6a16b5ec6ac845 Beata Fonferko-Shadrach Beata Fonferko-Shadrach true false d7c51b69270b644a11b904629fe56ab0 Joe Hollinghurst Joe Hollinghurst true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 10f39a4e9c2ee00d453cd84c10667ac8 Mark Rees Mark Rees true false f66d710c41a46bbb0f141e06c029a943 Inder Sawhney Inder Sawhney true false 7c8ac48bb6ae4281930e4138f94a51b6 Robert Powell Robert Powell true false a7e760887475de64ae7162a06aabc0b4 Michael Kerr Michael Kerr true false 1c3044b5ff7a6552ff5e8c9e3901c807 0000-0003-4396-5657 Owen Pickrell Owen Pickrell true false 2021-12-01 HDAT Purpose: The COVID-19 pandemic has increased mortality worldwide and those with chronic conditions may have been disproportionally affected. However, it is unknown whether the pandemic has changed mortality rates for people with epilepsy. We aimed to compare mortality rates in people with epilepsy in Wales during the pandemic with pre-pandemic rates. Methods: We performed a retrospective study using individual-level linked population-scale anonymised electronic health records. We identified deaths in people with epilepsy (DPWE), i.e. those with a diagnosis of epilepsy, and deaths associated with epilepsy (DAE), where epilepsy was recorded as a cause of death on death certificates. We compared death rates in 2020 with average rates in 2015–2019 using Poisson models to calculate death rate ratios. Results: There were 188 DAE and 628 DPWE in Wales in 2020 (death rates: 7.7/100,000/year and 25.7/100,000/year). The average rates for DAE and DPWE from 2015 to 2019 were 5.8/100,000/year and 23.8/100,000/year, respectively. Death rate ratios (2020 compared to 2015–2019) for DAE were 1.34 (95%CI 1.14–1.57, p<0.001) and for DPWE were 1.08 (0.99–1.17, p = 0.09). The death rate ratios for non-COVID deaths (deaths without COVID mentioned on death certificates) for DAE were 1.17 (0.99–1.39, p = 0.06) and for DPWE were 0.96 (0.87–1.05, p = 0.37). Conclusions: The significant increase in DAE in Wales during 2020 could be explained by the direct effect of COVID-19 infection. Non-COVID-19 deaths have not increased significantly but further work is needed to assess the longer-term impact. Journal Article Seizure - European Journal of Epilepsy 94 39 42 Elsevier BV 1059-1311 Data linkage, electronic health records, pandemic, COVID-19 1 1 2022 2022-01-01 10.1016/j.seizure.2021.11.017 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University External research funder(s) paid the OA fee (includes OA grants disbursed by the Library) This work was supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust . JH was supported by Health and Care research Wales [Project: SCF-18-1504 ]. AA, JH and RL were supported by the con-cov grant funded by the Medical Research Council (Grant No. MR/V028367/1 ), ADR Wales programme of work funded by the ADR UK (Grant ES/S007393/1 ) and the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales. This work was supported by staff funded as part of the Brain Repair and Intracranial Neurotherapeutics (BRAIN) Unit and the Wales Gene Park, infrastructure support groups funded by Welsh Government through Health and Care Research Wales. This study makes use of anonymised data held in the Secure Anonymised Information Linkage (SAIL) Databank. We would like to acknowledge all the data providers who make anonymised data available for research. Approval for the use of data in this study, within the SAIL Databank, was granted by an independent information governance review panel (project 0696). 2022-08-16T12:47:53.6969383 2021-12-01T14:09:55.1813543 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Helen Daniels 0000-0001-8899-0333 1 Arron Lacey 2 David Mikadze 3 Ashley Akbari 0000-0003-0814-0801 4 Beata Fonferko-Shadrach 5 Joe Hollinghurst 6 Ronan Lyons 0000-0001-5225-000X 7 Mark Rees 8 Inder Sawhney 9 Robert Powell 10 Michael Kerr 11 Owen Pickrell 0000-0003-4396-5657 12 58860__21860__0a1c5cf4f4b84a2aac3305ba672b92b5.pdf 58860.APCH054.VOR.pdf 2021-12-09T13:46:09.7287345 Output 943038 application/pdf Version of Record true Copyright: The Authors. This article is licensed under a Creative Commons Attribution 4.0 International License. true eng http://creativecommons.org/licenses/by/4.0/
title	Epilepsy mortality in Wales during COVID-19
spellingShingle	Epilepsy mortality in Wales during COVID-19 Helen Daniels Arron Lacey Ashley Akbari Beata Fonferko-Shadrach Joe Hollinghurst Ronan Lyons Mark Rees Inder Sawhney Robert Powell Michael Kerr Owen Pickrell
title_short	Epilepsy mortality in Wales during COVID-19
title_full	Epilepsy mortality in Wales during COVID-19
title_fullStr	Epilepsy mortality in Wales during COVID-19
title_full_unstemmed	Epilepsy mortality in Wales during COVID-19
title_sort	Epilepsy mortality in Wales during COVID-19
author_id_str_mv	a054902cb884be2476d0f097f0016294 b69d245574e754d2637cc9e76379fe11 aa1b025ec0243f708bb5eb0a93d6fb52 7d3f1e80939f2b8fab6a16b5ec6ac845 d7c51b69270b644a11b904629fe56ab0 83efcf2a9dfcf8b55586999d3d152ac6 10f39a4e9c2ee00d453cd84c10667ac8 f66d710c41a46bbb0f141e06c029a943 7c8ac48bb6ae4281930e4138f94a51b6 a7e760887475de64ae7162a06aabc0b4 1c3044b5ff7a6552ff5e8c9e3901c807
author_id_fullname_str_mv	a054902cb884be2476d0f097f0016294_*_Helen Daniels b69d245574e754d2637cc9e76379fe11__Arron Lacey aa1b025ec0243f708bb5eb0a93d6fb52__Ashley Akbari 7d3f1e80939f2b8fab6a16b5ec6ac845__Beata Fonferko-Shadrach d7c51b69270b644a11b904629fe56ab0__Joe Hollinghurst 83efcf2a9dfcf8b55586999d3d152ac6__Ronan Lyons 10f39a4e9c2ee00d453cd84c10667ac8__Mark Rees f66d710c41a46bbb0f141e06c029a943__Inder Sawhney 7c8ac48bb6ae4281930e4138f94a51b6__Robert Powell a7e760887475de64ae7162a06aabc0b4__Michael Kerr 1c3044b5ff7a6552ff5e8c9e3901c807_**_Owen Pickrell
author	Helen Daniels Arron Lacey Ashley Akbari Beata Fonferko-Shadrach Joe Hollinghurst Ronan Lyons Mark Rees Inder Sawhney Robert Powell Michael Kerr Owen Pickrell
author2	Helen Daniels Arron Lacey David Mikadze Ashley Akbari Beata Fonferko-Shadrach Joe Hollinghurst Ronan Lyons Mark Rees Inder Sawhney Robert Powell Michael Kerr Owen Pickrell
format	Journal article
container_title	Seizure - European Journal of Epilepsy
container_volume	94
container_start_page	39
publishDate	2022
institution	Swansea University
issn	1059-1311
doi_str_mv	10.1016/j.seizure.2021.11.017
publisher	Elsevier BV
college_str	Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id	facultyofmedicinehealthandlifesciences
hierarchy_top_title	Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id	facultyofmedicinehealthandlifesciences
hierarchy_parent_title	Faculty of Medicine, Health and Life Sciences
department_str	Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str	1
active_str	0
description	Purpose: The COVID-19 pandemic has increased mortality worldwide and those with chronic conditions may have been disproportionally affected. However, it is unknown whether the pandemic has changed mortality rates for people with epilepsy. We aimed to compare mortality rates in people with epilepsy in Wales during the pandemic with pre-pandemic rates. Methods: We performed a retrospective study using individual-level linked population-scale anonymised electronic health records. We identified deaths in people with epilepsy (DPWE), i.e. those with a diagnosis of epilepsy, and deaths associated with epilepsy (DAE), where epilepsy was recorded as a cause of death on death certificates. We compared death rates in 2020 with average rates in 2015–2019 using Poisson models to calculate death rate ratios. Results: There were 188 DAE and 628 DPWE in Wales in 2020 (death rates: 7.7/100,000/year and 25.7/100,000/year). The average rates for DAE and DPWE from 2015 to 2019 were 5.8/100,000/year and 23.8/100,000/year, respectively. Death rate ratios (2020 compared to 2015–2019) for DAE were 1.34 (95%CI 1.14–1.57, p<0.001) and for DPWE were 1.08 (0.99–1.17, p = 0.09). The death rate ratios for non-COVID deaths (deaths without COVID mentioned on death certificates) for DAE were 1.17 (0.99–1.39, p = 0.06) and for DPWE were 0.96 (0.87–1.05, p = 0.37). Conclusions: The significant increase in DAE in Wales during 2020 could be explained by the direct effect of COVID-19 infection. Non-COVID-19 deaths have not increased significantly but further work is needed to assess the longer-term impact.
published_date	2022-01-01T04:15:43Z
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score	11.013037

Epilepsy mortality in Wales during COVID-19

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