Objective

We aimed to investigate the association between telemedicine and the incidence of status epilepticus (SE) in patients with epilepsy (PWE) during the coronavirus disease 2019 (COVID-19) pandemic using a large population database in the United States.

Methods

We performed a retrospective analysis of a private, cloud-based healthcare platform (Explorys Inc., Cleveland, Ohio, USA). We compared each of the previously reported risk factors for SE, such as child, male, and refractory epilepsy, using the chi-square test or Fisher’s exact test in two groups: PWE with SE or without SE. We determined whether telemedicine could be a risk factor for the incidence of SE using multivariate binary logistic regression analysis incorporating statistically significant variables in the chi-square test or Fisher’s exact test (p < 0.05). Statistical significance was set at p < 0.05.

Results

We identified 1600 PWE with SE and 61,700 PWE without SE from May 2020 to May 2021. The proportion of children, males, refractory epilepsy, and telemedicine was higher in PWE with SE than in PWE without SE (children: 21.9% vs. 17.7%, p < 0.001; male: 52.5% vs. 48.2%, p = 0.001; refractory epilepsy: 20.6% vs. 8.2%, p < 0.001; telemedicine: 42.5% vs. 23.6%, p < 0.001). The multivariate binary logistic regression model identified four significant variables as follows: child (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.17–1.50), male (OR, 1.19; 95% CI, 1.07–1.31), refractory epilepsy (OR, 2.44; 95% CI, 2.15–2.77), and telemedicine (OR, 2.29; 95% CI, 2.07–2.54).

Conclusion

Telemedicine might be associated with an increased risk of SE in PWE during the COVID-19 pandemic.

中文翻译：

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COVID-19 大流行期间远程医疗与癫痫持续状态发生率之间的关联

 客观的

我们的目的是利用美国的大型人口数据库，调查 2019 年冠状病毒病 (COVID-19) 大流行期间远程医疗与癫痫患者 (PWE) 癫痫持续状态 (SE) 发病率之间的关联。

 方法

我们对基于云的私有医疗保健平台（Explorys Inc.，美国俄亥俄州克利夫兰）进行了回顾性分析。我们使用卡方检验或 Fisher 精确检验在两组中比较了先前报道的 SE 危险因素，例如儿童、男性和难治性癫痫：PWE 伴 SE 或不伴 SE。我们使用多元二元 Logistic 回归分析确定远程医疗是否可能是 SE 发病率的危险因素，并结合卡方检验或 Fisher 精确检验中的统计显着变量 ( p < 0.05)。统计显着性设定为p < 0.05。

 结果

从 2020 年 5 月到 2021 年 5 月，我们确定了 1600 名患有 SE 的 PWE 和 61,700 名不患有 SE 的 PWE。患有 SE 的 PWE 中儿童、男性、难治性癫痫和远程医疗的比例高于不患有 SE 的 PWE（儿童：21.9％ vs. 17.7％） ， p < 0.001；男性：52.5% vs. 48.2%， p = 0.001；难治性癫痫：20.6% vs. 8.2%， p < 0.001；远程医疗：42.5% vs. 23.6%， p < 0.001）。多元二元逻辑回归模型确定了四个显着变量，如下：儿童（比值比 [OR]，1.32；95% 置信区间 [CI]，1.17–1.50）、男性（OR，1.19；95% CI，1.07–1.31） 、难治性癫痫（OR，2.44；95% CI，2.15–2.77）和远程医疗（OR，2.29；95% CI，2.07–2.54）。

 结论

在 COVID-19 大流行期间，远程医疗可能与 PWE 中 SE 的风险增加有关。