Did the COVID‐19 pandemic silence the needs of people with epilepsy?

  • Tiziana Granata
    Epilepsy Unit, Department of Pediatric Neuroscience. Fondazione IRCCS Istituto Neurologico Carlo Besta Milano Italy. Member of ERN EpiCARE
  • Francesca Bisulli
    IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy. Member of ERN EpiCARE
  • Alexis Arzimanoglou
    Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology in Children University Hospitals of Lyon (HCL), Coordinator of the ERN EpiCARE and of the Brain Dynamics and Cognition Team (DYCOG),INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center Lyon France
  • Rodrigo Rocamora
    Epilepsy Monitoring Unit, Department of Neurology Hospital del Mar Barcelona Spain. Member of ERN EpiCARE

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<jats:title>Abstract</jats:title><jats:p><jats:italic>Aims</jats:italic>. The COVID‐19 pandemic shook European healthcare systems, with unavoidable gaps in the management of patients with chronic diseases. We describe the impact of the pandemic on epilepsy care in three tertiary epilepsy centres from Spain and Italy, the most affected European countries.</jats:p><jats:p><jats:italic>Methods</jats:italic>. The three epilepsy centres, members of the European EpiCARE network, manage more than 5,700 people with epilepsy. In Bologna and Barcelona, the hospitals housing the epilepsy centres were fully converted into COVID‐19 units. We describe the reorganization of the clinics and report on the frequency of SARS‐CoV‐2 in people with epilepsy as well as the frequency of seizures in patients admitted to the COVID units. Finally, we elaborate on critical issues regarding the second phase of the pandemic.</jats:p><jats:p><jats:italic>Results</jats:italic>. The activities related to epilepsy care were reduced to less than 10% and were deprioritized. Discharges were expedited and elective epilepsy surgeries, including vagal nerve stimulator implantations, cancelled. Hospitalizations and EEG examinations were limited to emergencies. The outpatient visits for new patients were postponed, and follow‐up visits mostly managed by telehealth. Antiseizure medication weaning plans and changes in vagal nerve stimulator settings were halted. Among the 5,700 people with epilepsy managed in our centres, only 14 tested positive for SARS‐CoV‐2, without obvious impact on their epilepsy. None of the 2,122 patients admitted to COVID units experienced seizures among the early symptoms.</jats:p><jats:p><jats:italic>Conclusion</jats:italic>. Epilepsy care was negatively impacted by the pandemic, irrespective of COVID‐19 epidemiology or conversion of the hospital into a COVID‐19 centre. The pandemic did not silence the needs of people with epilepsy, and this must be considered in the planning of the second phase.</jats:p>

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