COVID-19 May Increase Risk of Seizures After Infection, Study Finds

People who are infected with SARS-CoV-2, the virus that leads to COVID-19, are more likely to develop seizures or epilepsy in 6 months than people who have an influenza infection, according to a recent study published online in Neurology.

“While the overall risk of developing seizures or epilepsy was low—less than 1% of all people with COVID-19—given the large number of people who have been infected with COVID-19, this could result in increases in the number of people with seizures and epilepsy,” said study author Arjune Sen, MD, PhD, of the University of Oxford, in a statement. “In addition, the increased risk of seizures and epilepsy in children gives us another reason to try to prevent COVID-19 infections in kids.”

Using the TriNetX Analytics health records network for people with COVID-19 infections, the researchers matched those patients with someone similar in age, sex, and other factors who received an influenza diagnosis during the same time period. The study included 152,745 people each in the COVID-19 and influenza groups. None of the participants had a history of epilepsy or recurrent seizure diagnosis.

The overall incidence of seizure development within 6 months of COVID-19 infection was 0.81% (95% CI, 0.75-0.88), and the risk for this was 55% greater compared with patients who had an influenza infection (HR, 1.55; 95% CI, 1.39-1.74; P < .0001). Overall epilepsy incidence was 0.30% (95% CI, 1.87-1.54), and study participants with a diagnosed COVID-19 case had an 87% greater risk of developing epilepsy vs those with influenza (HR, 1.87; 95% CI, 1.54-2.28; P < .0001). Furthermore, the rates of new case epilepsy seizures in people who had COVID-19 was 0.94%, with patients again having a 55% greater risk (HR, 1.55; 95% CI, 1.40-1.72; P < .0001) vs those who had influenza.

In addition, the risks of epilepsy or seizures after COVID-19 infection was higher for children (< 16 years; n = 43,231) and adults (> 16 years; n = 108,116) vs after influenza infection:

• Children: 1.34% vs 0.69% (HR, 1.85; 95% CI, 1.54-2.22; P < .0001)
• Adults: 0.84% vs 0.54% (HR, 1.56; 95% CI, 1.37-1.77; P < .0001)

The markedly different results seen between the children and adults were unexpected, the researchers noted, even though prior research shows that COVID-19 has been found to affect children and adults differently.

Additionally, the researchers acknowledge that they were unable to identify which specific virus variants people were infected with, which may have influenced outcomes. Other limitations mentioned were unknown completeness of records, no validation of diagnosis, and lack of information of socioeconomic and lifestyle factors.

With epilepsy and seizures being rare outcomes of COVID-19 infection, the researchers support continued pooling of data across multiple health centers along with open access and transparent repositories and reporting of epilepsy and seizures post COVID-19.

“People should interpret these results cautiously since the overall risk is low,” Sen said. “We do, however, recommend that health care professionals pay particular attention to individuals who may have more subtle features of seizures, such as focal aware seizures, where people are alert and aware of what is going on, especially in the 3 months following a less severe COVID-19 infection.”

Reference

Taquet M, Devinsky O, Cross JH, Harrison PJ, Sen A. Incidence of epilepsy and seizures over the first 6 months after a COVID-19 diagnosis: a retrospective cohort study. Neurology. Published online November 16, 2022. doi:10.1212/wnl.0000000000201595