New-Onset Refractory Status Epilepticus Secondary to COVID-19 Infection in Adults: A Systematic Review

Abstract

Aabiya Arif,1 Yeny Chavarria,2 Mohammad Aadil Qamar,1 Sameer Saleem Tebha,3 Mehwish Butt,3 Khulud Qamar,4 Abubakr Yosufi5 1Medical School, Ziauddin University, Karachi, Sindh, Pakistan; 2Department of Neurology, University of California, Irvine, CA, USA; 3Department of Neurosurgery and Neurology, Jinnah Medical and Dental College, Karachi, Sindh, Pakistan; 4Department of Medicine, Dow Medical College, Karachi, Sindh, Pakistan; 5Medical School, Kabul University of Medical Sciences, Kabul, AfghanistanCorrespondence: Abubakr Yosufi, Dean’s Office, Kabul University of Medical Sciences, Kabul, Afghanistan, Tel [phone], Email [email protected]: New-onset refractory status epilepticus (NORSE) has been reported in the scientific literature as a phenomenon associated with the COVID-19 infection. Given the resurgence of the newer variants of COVID-19 added with its multi-system manifestations, this project was conducted to study the clinical picture of NORSE secondary to COVID-19 infection.Methods: Three electronic databases were searched using an extensive search strategy from November 2019 to December 2021. Patients reporting NORSE secondary to COVID-19 were included in this review. The status epilepticus severity score (STESS) was calculated by the study authors for individual patients. Statistical analysis was performed using SPSS version 26 with a p-value < 0.05 as statistically significant.Results: After screening, 12 patients were included in this study with a mean age of 61.6 ± 19.0-year olds. The most common type of status epilepticus reported in our study population was non-convulsive status epilepticus (NCSE) (7 out of 12 patients, 58.3%). The linear regression model revealed that STESS scores were significantly influenced by patients’ age (p = 0.004) and intra-hospital occurrence (IHO) of status epilepticus (p = 0.026). Overall, 8 patients (66.7%) were discharged without complications.Conclusion: Given the observed association of STESS with the aging population and IHO of status epilepticus, special attention is due to the caretakers of this population, while further studies are needed to further build upon this review.Keywords: new-onset refractory status epilepticus, COVID-19, status epilepticus severity score, status epilepticus, NORSE, FIRES

Keywords

• new-onset refractory status epilepticus
• covid-19
• status epilepticus severity score
• status epilepticus
• norse
• fires.