Incidencija akutnih simptomatskih napadaja kod bolesnika s COVID-19: monocentrično istraživanje

The most common neurological symptoms in patients with SARS-CoV-2 infection are headache, myalgia, encephalopathy, dizziness, dysgeusia and anosmia, making more than 90 percent of neurological manifestations of COVID-19. Other neurological manifestations such as stroke, movement disorder symptoms or epileptic seizures are rare but rather devastating, with possible lethal outcome. The primary aim of this study was to estimate the prevalence of acute symptomatic seizures among COVID-19 patients, while secondary aim was to determine their possible etiology. Out of 5382 patients with COVID-19 admitted to Dubrava University Hospital from November 1, 2020 until June 1, 2021, 38 (seizure rate 0.7%) of them had acute symptomatic seizures. Of these 38 patients, 29 (76.3%) had new-onset epileptic seizures and nine (23.7%) patients with previous epilepsy history had breakthrough seizures during COVID-19. Although acute symptomatic seizures are an infrequent complication of COVID-19, seizure risk must be considered in these patients, particularly in the group of patients with a severe course of the disease. Accumulation of proinflammatory cytokines may contribute to the occurrence of seizures in patients with COVID-19, but seizures may also be secondary to primary brain pathology related to COVID-19, such as stroke or encephalitis.Najčešći neurološki simptomi kod bolesnika s infekcijom SARS-CoV-2 su glavobolja, mialgija, encefalopatija, vrtoglavica, disgeuzija i anosmija, a čine više od 90% neuroloških manifestacija ove bolesti. Ostala neurološka zbivanja poput moždanog udara, poremećaja pokreta ili epileptičkih napada nisu česta, ali su potencijalno teške komplikacije s mogućim smrtnim ishodom. Primarni cilj ove studije bio je procijeniti učestalost akutnih simptomatskih napadaja kod bolesnika s COVID-19, dok je sekundarni cilj bio utvrditi njihovu moguću etiologiju. Od ukupno 5382 bolesnika hospitaliziranih u Kliničkoj bolnici Dubrava od 1. studenoga 2020. godine do 1. lipnja 2021. njih 38 (0,7%) je imalo akutne simptomatske napadaje. Od tih 38 bolesnika 29 (76,3%) ih je imalo novonastale epileptičke napadaje bez ranije anamneze epilepsije, dok je njih 9 (23,7%) imalo anamnezu dobro kontrolirane epilepsije uz pojavu epileptičkih napadaja tijekom bolesti COVID-19. Iako su akutni simptomatski napadaji rijetka komplikacija bolesti COVID-19, treba razmišljati o epileptičkim napadajima kod ovih bolesnika, osobito kod onih s teškim oblikom bolesti. Nakupljanje proupalnih citokina može doprinijeti pojavi napadaja u bolesnika s COVID-19, ali napadaji mogu također biti posljedica primarnog zbivanja na mozgu uslijed bolesti COVID-19, poput moždanog udara ili encefalitisa