CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2021; 79(04): 315-320
DOI: 10.1590/0004-282X-ANP-2020-0555
ARTICLE

Electroencephalographic findings among inpatients with COVID-19 in a tertiary hospital from a middle-income country

Achados eletroencefalográficos entre pacientes internados com COVID-19 em um hospital terciário de um país em desenvolvimento
1   Hospital Santa Marcelina, Departamento de Neurologia, São Paulo SP, Brazil.
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1   Hospital Santa Marcelina, Departamento de Neurologia, São Paulo SP, Brazil.
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1   Hospital Santa Marcelina, Departamento de Neurologia, São Paulo SP, Brazil.
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1   Hospital Santa Marcelina, Departamento de Neurologia, São Paulo SP, Brazil.
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1   Hospital Santa Marcelina, Departamento de Neurologia, São Paulo SP, Brazil.
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1   Hospital Santa Marcelina, Departamento de Neurologia, São Paulo SP, Brazil.
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1   Hospital Santa Marcelina, Departamento de Neurologia, São Paulo SP, Brazil.
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1   Hospital Santa Marcelina, Departamento de Neurologia, São Paulo SP, Brazil.
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1   Hospital Santa Marcelina, Departamento de Neurologia, São Paulo SP, Brazil.
› Institutsangaben

ABSTRACT

Background: In 2019, the world witnessed the emergence of a new type of coronavirus - the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The spectrum of coronavirus disease 2019 (COVID-19) is variable, and amongst its manifestations are neurological implications. Objective: This report aimed to describe electroencephalographic findings in COVID-19 patients from a general tertiary hospital in São Paulo, Brazil. Methods: It was a retrospective, observational, and non-interventional study. Data were collected anonymously, comprising inpatients from Mar 1 to Jun 30, 2020, either confirmed (positive RT-PCR) or probable cases (CO-RADS 4/5) who had performed EEG during hospitalization. Results: Twenty-eight patients were enrolled, 17 (60.7%) women and 11 men, with a median age of 58 (minimum and maximum: 18-86; IQR 23.5). COVID-19 diagnosis was confirmed in 22 (78.5%). Twenty-one patients (75%) had severe disease, requiring mechanical ventilation due to acute respiratory distress syndrome (ARDS); 16 (57.1%) patients developed adjunct sepsis throughout hospitalization. There was no specific pattern found for COVID-19 in EEG. No patients presented with status epilepticus or electrographic events; most patients developed an encephalopathic pattern, as seen in most studies, with a high prevalence of altered mental status as an indication for EEG. Adjunct sepsis was associated with higher mortality. Conclusions: EEG presents as a useful tool in the context of COVID-19, as in other conditions, to differentiate nonconvulsive status epilepticus (NCSE) from encephalopathy and other causes of mental status alterations. Further studies are required to analyze whether there might be a specific EEG pattern to the disease.

RESUMO

Antecedentes: Em 2019, testemunhou-se o surgimento de um novo tipo de coronavírus - o coronavírus associado à síndrome da angústia respiratória tipo 2 (SARS-CoV-2). O espectro da doença associada ao novo coronavírus, a COVID-19, é variável e, dentre suas manifestações, há implicações neurológicas. Objetivos: O presente estudo objetivou descrever achados eletroencefalográficos em pacientes com COVID-19 internados em um hospital terciário em São Paulo. Métodos: Tratou-se de estudo observacional, retrospectivo e não-intervencionista, realizado por meio de coleta anônima e retrospectiva de dados de prontuário médico de pacientes com diagnóstico confirmado (RT-PCR positivo) ou provável (CO-RADS 4 ou 5), que realizaram eletroencefalograma durante internação hospitalar. Resultados: Vinte e oito pacientes foram elencados, 17 (60,7%) mulheres e 11 homens. O diagnóstico de COVID-19 foi confirmado em 22 (78,5%) dos casos. Dos pacientes, 21 (75%) apresentaram a doença, requerendo suporte ventilatório, e 16 (57,1%) desenvolveram sepse sobreposta. Não houve padrão específico de EEG para COVID-19, e nenhum paciente apresentou estado de mal epiléptico ou crise eletrográfica; a maioria desenvolveu padrão de encefalopatia, com alentecimento da atividade cerebral, sendo a alta prevalência de alteração de estado mental a indicação para o exame. A sepse sobreposta foi associada a um pior desfecho, com maior mortalidade. Conclusão: No contexto da COVID-19, o EEG figura como ferramenta importante, auxiliando, como em outras condições, na diferenciação entre estado de mal epiléptico, encefalopatia e outras causas de alteração do estado mental. Estudos adicionais são necessários para avaliar a existência de padrão específico de alteração eletroencefalográfica na COVID-19.

Authors’ contributions:

All authors contributed to text-proofreading and data collection. LAC: was responsible for database reviewing and main text writing. JFST: was responsible for graphics design and descriptive statistics. MAB and Mariana AB additionally reviewed electroencephalograms. SMDB, LAC, MSGR, and MAB were responsible for study conception.




Publikationsverlauf

Eingereicht: 27. November 2020

Angenommen: 16. Februar 2021

Artikel online veröffentlicht:
01. Juni 2023

© 2021. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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