Impact of COVID-19 on quality of life in people with epilepsy, and a multinational comparison of clinical and psychological impacts
Document Type
Article
Publication Date
4-1-2021
Abstract
Background: This study aimed to determine the relationship among the clinical, logistic, and psychological impacts of COVID-19 on people with epilepsy (PWE), and the impact of COVID-19 on the quality of life. Method: This is a cross-sectional anonymized web-based study on PWE, using an online questionnaire to assess the clinical, logistic, and psychological impacts of COVID-19, including Hospital Anxiety Depression Scale (HADS) and Quality of Life in Epilepsy Inventory (QOLIE-31). Result: 461 patients were recruited, with a mean age of 39.21 +/- 15.88 years, majority female (50.1%), with focal epilepsy (54.0%), and experienced seizures at least once yearly (62.5%). There were 13.0% experienced seizure worsening during COVID-19 period, which were associated with baseline seizures frequency >= 1 per month (32.0% vs. 6.2%, p < 0.001), worries of seizure worsening (18.0% vs. 10.9%, p < 0.001), difficulty to go emergency unit (24.4% vs. 10.4%, p < 0.001), AEDs ran out of stock (23.2% vs. 11.6%, p < 0.05), self-adjustment of AED dosages (26.4% vs. 11.3%, p < 0.001), inadequate sleep (22.4% vs. 9.2%, p < 0.001), and stress (23.4% vs.10.1%, p < 0.01). Participants experiencing seizure worsening reported greater anxiety (8.10 +/- 5.011 vs. 4.84 +/- 3.989, p < 0.001) and depression (6.05 +/- 3.868 vs. 3.86 +/- 3.589, p < 0.001). Logistic regression showed baseline seizures frequency >1 per month (OR, 14.10) followed by anxiety (OR, 3.90), inadequate sleep (OR, 0.37), and treated in UMMC (OR, 0.31) as the predictors for seizure worsening during COVID-19 period. Poorer total QOLIE-31 score was noted in those with seizure worsening (48.01 +/- 13.040 vs. 62.15 +/- 15.222, p < 0.001). Stepwise regression highlighted depression as the main negative predictor for quality of life (beta = -0.372, p < 0.001), followed by anxiety (b = -0.345, p < 0.001). Conclusion: A significant number of PWE experienced seizure worsening during COVID-19 period, which was related to the clinical, logistic, and psychological factors. Quality of life was affected by the seizure worsening and the psychological stress. (C) 2021 Elsevier Inc. All rights reserved.
Keywords
COVID-19, Epilepsy, Seizure control, Quality of life, Depression, Anxiety
Divisions
fac_med
Funders
University of Malaya Faculty of Medicine Postgraduate Scheme,Impact Oriented Interdisciplinary Research Grant (IIRG) Programme (IIRG003A2020HWB)
Publication Title
Epilepsy & Behavior
Volume
117
Publisher
Elsevier
Publisher Location
525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA