Socio-economic impact on epilepsy outside of the nation-wide COVID-19 pandemic area.
Socio-economic impact on epilepsy outside of the nation-wide COVID-19 pandemic area.
复制标题
DOI：
10.1016/j.yebeh.2021.107886
复制
发表时间：
2021-04
影响因子：
2.6
通讯作者：
Maruyama, Hirofumi
中科院分区：
文献类型：
--
作者：
Neshige, Shuichiro;Aoki, Shiro;Shishido, Takeo;Morino, Hiroyuki;Iida, Koji;Maruyama, Hirofumi
识别在2019年新型冠状病毒病（COVID-19）大流行之前需要广泛护理的癫痫患者（PWE），该疾病对医疗保健和社会经济状况产生了全球性影响。入组了2019年3月至2020年8月期间在位于COVID-19非大流行地区的广岛大学医院癫痫中心接受治疗的连续性PWE。我们评估了与COVID-19大流行开始后前6个月相比，与前6个月癫痫发作加重（癫痫发作频率增加）相关的临床和社会经济因素。在接受评估的196名PWE中（平均年龄为37.8 ± 16.2岁），有33名PWE（16.8%）在大流行开始后癫痫发作频率增加。癫痫发作次数增加的癫痫患者与独居有显著关联（p < 0.001），较高的发作频率（p < 0.001），MRI阴性结果（p = 0.020），分离性癫痫发作史（p < 0.001）、情绪障碍（p < 0.001）、失眠（p < 0.001）和高心理应激水平（p = 0.024）。多变量logistic回归分析显示，“独居”（优势比（OR）3.69; 95%CI 1.29-10.52）、“基线时癫痫发作频率高”（OR 4.53; 95%CI 1.63-12.57）和“失眠合并症”（OR 9.55; 95%CI 3.71-24.55）与癫痫发作加重独立相关。即使在非流行区，PWE也有癫痫发作加重，提示临床医生应在疫情发生前对患者进行心理健康筛查，以提供护理，减轻负担，并防止PWE的社会隔离。这应该得到解决，特别是在患者与医学难治性癫痫发作失眠谁独居。
To identify people with epilepsy (PWE) who required extensive care before the novel coronavirus disease 2019 (COVID-19) pandemic that had world-wide impacts on medical care and on socio-economic conditions. Consecutive PWE who were treated at the epilepsy center of Hiroshima University Hospital, which was located in the COVID-19 non-pandemic area, between March 2019 and August 2020 were enrolled. We evaluated clinical and socioeconomic factors that were associated with seizure exacerbation (an increase in seizure frequency) during the first 6 months after the COVID-19 pandemic started compared with the previous 6 months. Among the 196 PWE who were evaluated (mean age was 37.8 ± 16.2 years), there were 33 PWE (16.8%) whose seizure frequency had increased after the pandemic began. People with epilepsy with a seizure increase showed a significant association with living alone (p < 0.001), a higher seizure frequency (p < 0.001), negative findings on MRI (p = 0.020), history of dissociative seizure (p < 0.001), mood disorders (p < 0.001), insomnia (p < 0.001), and high psychological stress levels (p = 0.024) at baseline compared with PWE without seizure exacerbation. Multivariate logistic regression analysis revealed that “living alone” (odds ratio (OR) 3.69; 95%CI 1.29–10.52), “high seizure frequency at baseline” (OR 4.53; 95%CI 1.63–12.57), and “comorbidity of insomnia” (OR 9.55; 95%CI 3.71–24.55) were independently associated with seizure exacerbation. Even in the non-pandemic area, PWE had seizure exacerbation, suggesting that clinicians should screen patients’ mental health before the outbreak to provide care, reduce the burden, and prevent social isolation in PWE. This should be addressed particularly in patients with medically refractory seizures with insomnia who live alone.
登录
查看更多内容
影响因子：
3
作者：
Hu, Meiling;Zhang, Chenqi;Sun, Hongbin
通讯作者：
Sun, Hongbin
影响因子：
9.9
作者：
Fountain, Nathan B.;Van Ness, Paul G.;Stecker, Mona
通讯作者：
Stecker, Mona
影响因子：
2.6
作者：
Alkhotani, Amal;Siddiqui, Muhammad, I;Baothman, Renad
通讯作者：
Baothman, Renad
影响因子：
--
作者：
Kessler, RC;Barker, PR;Zaslavsky, AM
通讯作者：
Zaslavsky, AM
影响因子：
5.6
作者：
Hao, Xiaoting;Zhou, Dong;Yan, Bo
通讯作者：
Yan, Bo