A study of Electroencephalography Findings and its Prognostic Value in Severe COVID-19 Patients Admitted at Intensive Care Unit

Abstract

Objective: To study electroencephalography patterns in COVID-19 patients admitted to intensive care unit and find the association of these patterns with outcome. Study Design: Comparative cross-sectional study. Place and Duration of Study: Intensive Care Unit, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Nov 2020 to Mar 2021. Methodology: Eighteen electroencephalograms in COVID-19 patients with Encephalopathy were recorded using a 10-20 electrode system. The duration of each recording was 30 minutes. Traces were analysed by a neurologist for delta slowing, epileptiform discharges, and posterior dominant rhythm. Generalised slowing was classified as mild (background slowing), moderate (intermittent slowing) and severe (continuous slowing). Results: A total of 18 COVID-19 patients, with a mean age of 63±16.02 years, underwent electroencephalography recording of 30 min duration. Diabetes mellitus and ischemic heart disease were the most common co-morbidity (7, 38.9%), followed by CKD. Non-specific generalised slowing was observed in all EEGs. No epileptiform discharges or focality were seen. Posterior Dominant Rhythm has been related to a good outcome. At the same time, severe Encephalopathy (Richmond Agitation-Sedation Scale of -3 to -5) was associated with poor outcomes (p-value<0.05). Conclusion: Patients with Posterior Dominant Rhythm had more chances of having good outcomes, while patients with severe encephalopathy findings on EEG were more at risk of poor outcomes.

Keywords

• COVID-19
• Electroencephalography
• Encephalopathy
• Electroencephalogram (EEG)
• Richmond Agitation-Sedation Scale