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Epilepsy and the risk of COVID-19-related hospitalization and death: A population study
Huw Strafford,
Joe Hollinghurst,
Arron Lacey 
,
Ashley Akbari ,
Alan Watkins ,
Jan Paterson,
Daniel Jennings,
Ronan Lyons ,
Robert Powell,
Michael P. Kerr,
Richard F. Chin ,
Owen Pickrell
,
Ashley Akbari ,
Alan Watkins ,
Jan Paterson,
Daniel Jennings,
Ronan Lyons ,
Robert Powell,
Michael P. Kerr,
Richard F. Chin ,
Owen Pickrell
Epilepsia
Swansea University Authors:
Huw Strafford, Joe Hollinghurst, Arron Lacey , Ashley Akbari , Alan Watkins , Ronan Lyons , Robert Powell, Owen Pickrell
-
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DOI (Published version): 10.1111/epi.17910
Abstract
ObjectivePeople with epilepsy (PWE) may be at an increased risk of severe COVID-19. It is important to characterize this risk to inform PWE and for future health and care planning. We assessed whether PWE were at higher risk of being hospitalized with, or dying from, COVID-19.MethodsWe performed a r...
| Published in: | Epilepsia |
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| ISSN: | 0013-9580 1528-1167 |
| Published: |
Wiley
2024
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa65804 |
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| Abstract: |
ObjectivePeople with epilepsy (PWE) may be at an increased risk of severe COVID-19. It is important to characterize this risk to inform PWE and for future health and care planning. We assessed whether PWE were at higher risk of being hospitalized with, or dying from, COVID-19.MethodsWe performed a retrospective cohort study using linked, population-scale, anonymized electronic health records from the SAIL (Secure Anonymised Information Linkage) databank. This includes hospital admission and demographic data for the complete Welsh population (3.1 million) and primary care records for 86% of the population. We identified 27 279 PWE living in Wales during the study period (March 1, 2020 to June 30, 2021). Controls were identified using exact 5:1 matching (sex, age, and socioeconomic status). We defined COVID-19 deaths as having International Classification of Diseases, 10th Revision (ICD-10) codes for COVID-19 on death certificates or occurring within 28 days of a positive SARS-CoV-2 polymerase chain reaction (PCR) test. COVID-19 hospitalizations were defined as having a COVID-19 ICD-10 code for the reason for admission or occurring within 28 days of a positive SARS-CoV-2 PCR test. We recorded COVID-19 vaccinations and comorbidities known to increase the risk of COVID-19 hospitalization and death. We used Cox proportional hazard models to calculate hazard ratios.ResultsThere were 158 (.58%) COVID-19 deaths and 933 (3.4%) COVID-19 hospitalizations in PWE, and 370 (.27%) deaths and 1871 (1.4%) hospitalizations in controls. Hazard ratios for COVID-19 death and hospitalization in PWE compared to controls were 2.15 (95% confidence interval [CI] = 1.78–2.59) and 2.15 (95% CI = 1.94–2.37), respectively. Adjusted hazard ratios (adjusted for comorbidities) for death and hospitalization were 1.32 (95% CI = 1.08–1.62) and 1.60 (95% CI = 1.44–1.78).SignificancePWE are at increased risk of being hospitalized with, and dying from, COVID-19 when compared to age-, sex-, and deprivation-matched controls, even when adjusting for comorbidities. This may have implications for prioritizing future COVID-19 treatments and vaccinations for PWE. |
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| Keywords: |
electronic health records, health care utilization, real world evidence, routinely collected data |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
This study is funded by Health and Care Research Wales. The views expressed are those of the authors and not nec-essarily those of Health and Care Research Wales or the Welsh Government. This work was supported by Health Data Research UK, which receives its funding from HDR UK (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, and Wellcome Trust. J.H. was supported by Health and Care Research Wales (Project SCF- 18- 1504). A.A., J.H., and R.A.L. were supported by the Con- COV grant funded by the Medical Research Council (grant number: MR/V028367/1); ADR Wales funded by the ADR UK (grant ES/S007393/1); and the Wales COVID- 19 Evidence Centre funded by Health and Care Research Wales. This study makes use of anonymized data held in the Secure Anonymised Information Linkage (SAIL) da-tabank. We would like to acknowledge all the data pro-viders who make anonymized data available for research. Approval for the use of data in this study, within the SAIL atabank, was granted by an independent information governance review panel (Project 0911). We acknowledge the help of Epilepsy Action volunteers who have assisted in all stages of this project; in particular we would like to thank Nigel Bennett, Sara Edwards, Carys Jones, Rebecca Longley, and Sarah Thorpe. For the purpose of open ac-cess, the author has applied a CC- BY public copyright li-cense to any author accepted manuscript version arising from this submission. |