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Epilepsy and the risk of COVID-19-related hospitalization and death: A population study

Huw Strafford, Joseph Hollinghurst, Arron Lacey Orcid Logo, Ashley Akbari Orcid Logo, Alan Watkins Orcid Logo, Jan Paterson, Daniel Jennings, Ronan Lyons Orcid Logo, Robert Powell, Michael P. Kerr, Richard F. Chin Orcid Logo, Owen Pickrell Orcid Logo

Epilepsia, Volume: 65, Issue: 5, Pages: 1383 - 1393

Swansea University Authors: Huw Strafford, Joseph Hollinghurst, Arron Lacey Orcid Logo, Ashley Akbari Orcid Logo, Alan Watkins Orcid Logo, Ronan Lyons Orcid Logo, Robert Powell, Owen Pickrell Orcid Logo

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DOI (Published version): 10.1111/epi.17910

Abstract

Objective: People 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. Methods: We performe...

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Published in: Epilepsia
ISSN: 0013-9580 1528-1167
Published: Wiley 2024
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URI: https://cronfa.swan.ac.uk/Record/cronfa65804
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2024-10-08T11:37:46.0423570</datestamp><bib-version>v2</bib-version><id>65804</id><entry>2024-03-10</entry><title>Epilepsy and the risk of COVID-19-related hospitalization and death: A population study</title><swanseaauthors><author><sid>a6389fc6d4d18e7b67033ee04b381e43</sid><firstname>Huw</firstname><surname>Strafford</surname><name>Huw Strafford</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>d7c51b69270b644a11b904629fe56ab0</sid><firstname>Joseph</firstname><surname>Hollinghurst</surname><name>Joseph Hollinghurst</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>b69d245574e754d2637cc9e76379fe11</sid><ORCID>0000-0001-7983-8073</ORCID><firstname>Arron</firstname><surname>Lacey</surname><name>Arron Lacey</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>aa1b025ec0243f708bb5eb0a93d6fb52</sid><ORCID>0000-0003-0814-0801</ORCID><firstname>Ashley</firstname><surname>Akbari</surname><name>Ashley Akbari</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>81fc05c9333d9df41b041157437bcc2f</sid><ORCID>0000-0003-3804-1943</ORCID><firstname>Alan</firstname><surname>Watkins</surname><name>Alan Watkins</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>83efcf2a9dfcf8b55586999d3d152ac6</sid><ORCID>0000-0001-5225-000X</ORCID><firstname>Ronan</firstname><surname>Lyons</surname><name>Ronan Lyons</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>7c8ac48bb6ae4281930e4138f94a51b6</sid><firstname>Robert</firstname><surname>Powell</surname><name>Robert Powell</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>1c3044b5ff7a6552ff5e8c9e3901c807</sid><ORCID>0000-0003-4396-5657</ORCID><firstname>Owen</firstname><surname>Pickrell</surname><name>Owen Pickrell</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2024-03-10</date><deptcode>MEDS</deptcode><abstract>Objective: People 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. Methods: We 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&#x2009;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&#x2009;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&#x2009;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. Results: There 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] =&#x2009;1.78&#x2013;2.59) and 2.15 (95% CI&#x2009;=&#x2009;1.94&#x2013;2.37), respectively. Adjusted hazard ratios (adjusted for comorbidities) for death and hospitalization were 1.32 (95% CI&#x2009;=&#x2009;1.08&#x2013;1.62) and 1.60 (95% CI&#x2009;=&#x2009;1.44&#x2013;1.78). Significance: PWE 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.</abstract><type>Journal Article</type><journal>Epilepsia</journal><volume>65</volume><journalNumber>5</journalNumber><paginationStart>1383</paginationStart><paginationEnd>1393</paginationEnd><publisher>Wiley</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0013-9580</issnPrint><issnElectronic>1528-1167</issnElectronic><keywords>Electronic health records, health care utilization, real world evidence, routinely collected data</keywords><publishedDay>10</publishedDay><publishedMonth>5</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-05-10</publishedDate><doi>10.1111/epi.17910</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>SU Library paid the OA fee (TA Institutional Deal)</apcterm><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.</funders><projectreference/><lastEdited>2024-10-08T11:37:46.0423570</lastEdited><Created>2024-03-10T19:17:31.1241482</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>Huw</firstname><surname>Strafford</surname><order>1</order></author><author><firstname>Joseph</firstname><surname>Hollinghurst</surname><order>2</order></author><author><firstname>Arron</firstname><surname>Lacey</surname><orcid>0000-0001-7983-8073</orcid><order>3</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>4</order></author><author><firstname>Alan</firstname><surname>Watkins</surname><orcid>0000-0003-3804-1943</orcid><order>5</order></author><author><firstname>Jan</firstname><surname>Paterson</surname><order>6</order></author><author><firstname>Daniel</firstname><surname>Jennings</surname><order>7</order></author><author><firstname>Ronan</firstname><surname>Lyons</surname><orcid>0000-0001-5225-000X</orcid><order>8</order></author><author><firstname>Robert</firstname><surname>Powell</surname><order>9</order></author><author><firstname>Michael P.</firstname><surname>Kerr</surname><order>10</order></author><author><firstname>Richard F.</firstname><surname>Chin</surname><orcid>0000-0002-7256-3027</orcid><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>65804__29742__f7e99ece43ad452cad5b404b0243e0ce.pdf</filename><originalFilename>65804_VoR.pdf</originalFilename><uploaded>2024-03-18T17:12:31.9852434</uploaded><type>Output</type><contentLength>4571959</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; 2024 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by-nc/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling 2024-10-08T11:37:46.0423570 v2 65804 2024-03-10 Epilepsy and the risk of COVID-19-related hospitalization and death: A population study a6389fc6d4d18e7b67033ee04b381e43 Huw Strafford Huw Strafford true false d7c51b69270b644a11b904629fe56ab0 Joseph Hollinghurst Joseph Hollinghurst true false b69d245574e754d2637cc9e76379fe11 0000-0001-7983-8073 Arron Lacey Arron Lacey true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 81fc05c9333d9df41b041157437bcc2f 0000-0003-3804-1943 Alan Watkins Alan Watkins true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 7c8ac48bb6ae4281930e4138f94a51b6 Robert Powell Robert Powell true false 1c3044b5ff7a6552ff5e8c9e3901c807 0000-0003-4396-5657 Owen Pickrell Owen Pickrell true false 2024-03-10 MEDS Objective: People 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. Methods: We 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. Results: There 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). Significance: PWE 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. Journal Article Epilepsia 65 5 1383 1393 Wiley 0013-9580 1528-1167 Electronic health records, health care utilization, real world evidence, routinely collected data 10 5 2024 2024-05-10 10.1111/epi.17910 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University SU Library paid the OA fee (TA Institutional Deal) 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. 2024-10-08T11:37:46.0423570 2024-03-10T19:17:31.1241482 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Huw Strafford 1 Joseph Hollinghurst 2 Arron Lacey 0000-0001-7983-8073 3 Ashley Akbari 0000-0003-0814-0801 4 Alan Watkins 0000-0003-3804-1943 5 Jan Paterson 6 Daniel Jennings 7 Ronan Lyons 0000-0001-5225-000X 8 Robert Powell 9 Michael P. Kerr 10 Richard F. Chin 0000-0002-7256-3027 11 Owen Pickrell 0000-0003-4396-5657 12 65804__29742__f7e99ece43ad452cad5b404b0243e0ce.pdf 65804_VoR.pdf 2024-03-18T17:12:31.9852434 Output 4571959 application/pdf Version of Record true © 2024 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License true eng http://creativecommons.org/licenses/by-nc/4.0/
title Epilepsy and the risk of COVID-19-related hospitalization and death: A population study
spellingShingle Epilepsy and the risk of COVID-19-related hospitalization and death: A population study
Huw Strafford
Joseph Hollinghurst
Arron Lacey
Ashley Akbari
Alan Watkins
Ronan Lyons
Robert Powell
Owen Pickrell
title_short Epilepsy and the risk of COVID-19-related hospitalization and death: A population study
title_full Epilepsy and the risk of COVID-19-related hospitalization and death: A population study
title_fullStr Epilepsy and the risk of COVID-19-related hospitalization and death: A population study
title_full_unstemmed Epilepsy and the risk of COVID-19-related hospitalization and death: A population study
title_sort Epilepsy and the risk of COVID-19-related hospitalization and death: A population study
author_id_str_mv a6389fc6d4d18e7b67033ee04b381e43
d7c51b69270b644a11b904629fe56ab0
b69d245574e754d2637cc9e76379fe11
aa1b025ec0243f708bb5eb0a93d6fb52
81fc05c9333d9df41b041157437bcc2f
83efcf2a9dfcf8b55586999d3d152ac6
7c8ac48bb6ae4281930e4138f94a51b6
1c3044b5ff7a6552ff5e8c9e3901c807
author_id_fullname_str_mv a6389fc6d4d18e7b67033ee04b381e43_***_Huw Strafford
d7c51b69270b644a11b904629fe56ab0_***_Joseph Hollinghurst
b69d245574e754d2637cc9e76379fe11_***_Arron Lacey
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
81fc05c9333d9df41b041157437bcc2f_***_Alan Watkins
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
7c8ac48bb6ae4281930e4138f94a51b6_***_Robert Powell
1c3044b5ff7a6552ff5e8c9e3901c807_***_Owen Pickrell
author Huw Strafford
Joseph Hollinghurst
Arron Lacey
Ashley Akbari
Alan Watkins
Ronan Lyons
Robert Powell
Owen Pickrell
author2 Huw Strafford
Joseph Hollinghurst
Arron Lacey
Ashley Akbari
Alan Watkins
Jan Paterson
Daniel Jennings
Ronan Lyons
Robert Powell
Michael P. Kerr
Richard F. Chin
Owen Pickrell
format Journal article
container_title Epilepsia
container_volume 65
container_issue 5
container_start_page 1383
publishDate 2024
institution Swansea University
issn 0013-9580
1528-1167
doi_str_mv 10.1111/epi.17910
publisher Wiley
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 Objective: People 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. Methods: We 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. Results: There 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). Significance: PWE 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.
published_date 2024-05-10T20:29:02Z
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