COVID-19 Pandemic Led to Exacerbation of Health Issues Among People With Epilepsy

New survey findings published in the journal Epilepsy and Behavior suggest a need for novel approaches to care delivery and increased social support for people with epilepsy, a group of people who have been significantly impacted by the COVID-19 pandemic.

The cross-sectional study of 260 people with epilepsy collected data between October and December 2020, months following the onset of the pandemic in the United States. Survey responses indicated that approximately one-third of respondents experienced worsening of concurrent health conditions and a heightened fear of experiencing seizures, both of which led to a fear of seeking out care during the study period.

“One plausible explanation is that the loss of some health care services among [people with epilepsy] could increase reported mental and physical symptoms, and reluctance to seek medical care causes delays in treatment during the pandemic,” explained the researchers. Throughout the study period, 7% of respondents were diagnosed with COVID-19.

Multivariate logistic regression showed that respondents who reported a fear of seeking out health care were more likely to also report an exacerbated co-occurring health condition (aOR, 1.12; 95% CI, 1.01–1.26) and have an increased fear of having a seizure (aOR, 2.31; 95% CI, 1.14–4.68). Having more limited access to physical care during the study period was also associated with an increased fear of having a seizure (aOR 2.58; 95%CI 1.15–5.78).

“A significant correlation between fear of seeking health care services and co-occurring health conditions, and fear of seizure can indicate high levels of general anxiety in a pandemic situation, and worsening anxiety could be triggered by the stress scenario during the pandemic," the authors wrote. "Thus, epilepsy health care services should not be postponed, and people with epilepsy should be informed that measures are being taken to ensure hospital safety.”

More than half of patient reported stress (58%) and anxiety (57%) as a COVID-19 stressor, and nearly half reported an increase in social isolation. The multivariate analysis found that experiencing increased social isolation was significantly associated with exacerbated co-occurring health conditions (aOR 1.14; 95 CI% 1.01–1.29).

“Consistent with previous research, our results demonstrated that social isolation due to COVID-19 could lead to negative consequences for the physical health of different populations,” wrote the researchers. “Very few studies have examined how depression, anxiety, and social support relate to people with epilepsy during COVID-19, and there was a significant association between living alone and epilepsy with a higher seizure frequency."

The authors concluded that measures to prevent social isolation, including outside of the pandemic era, may be helpful for those living with epilepsy.

"These studies showed that lack of social support is associated with higher psychological distress, and preventing social isolation is essential for people with epilepsy even in the non-pandemic era," the authors wrote. "Therefore, providing greater opportunities for social connection will be critical to improving physical and mental health conditions and ultimately increasing people with epilepsy’s quality of life.”

Reference

Roghani A, Bouldin A, Mobasher H, et al. COVID-19 pandemic experiences among people with epilepsy: Effect on symptoms of co-occurring health conditions and fear of seizure. Epilepsy Behav. Published online April 4, 2023. doi: 10.1016/j.yebeh.2023.109206