Objective: People with epilepsy (PWE) may be at an increased risk of severe COVID-19. It is important to characterise 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 Secure Anonymised Information Linkage (SAIL) 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 (01/03/2020–30/06/2021). Controls were identified using exact 5:1 matching (sex, age and socioeconomic status).
We defined COVID-19 deaths as having 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 hospitalizations and deaths. We used Cox-proportional hazard models to calculate hazard ratios.
Results: There were 158 (0.58%) COVID-19 deaths and 933 (3.4%) COVID-19 hospitalisations in PWE, and 370 (0.27%) deaths and 1,871 (1.4%) hospitalizations in controls. Hazard ratios for COVID-19 deaths and hospitalisations in PWE compared to controls were 2.15 (95%CI 1.78–2.59) and 2.15 (1.94–2.37) respectively. Adjusted hazard ratios (adjusted for comorbidities) for deaths and hospitalizations were 1.32 (1.08–1.62) and 1.60 (1.44–1.78).
Significance: PWE are at increased risk of being hospitalised 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 prioritising future COVID-19 treatments and vaccinations for PWE.

Cite as

Strafford, H., Hollinghurst, J., Lacey, A., Akbari, A., Watkins, A., Paterson, J., Jennings, D., Lyons, R., Powell, H., Kerr, M., Chin, R. & Pickrell, W. 2024, 'Epilepsy and the risk of COVID-19 related hospitalisations and deaths: a population study', Epilepsia, 65(5), pp. 1383-1393. https://doi.org/10.1111/epi.17910

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Last updated: 24 May 2024
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