Abstract
Introduction: During the COVID-19 pandemic, electroencephalography (EEG) proved to be a useful tool to demonstrate brain involvement. Many studies reported non-reactive generalized slowing as the most frequent pattern and epileptiform activity in a minority of patients.
Objective: To investigate the prevalence of diffuse unreactive background attenuation or suppression and its correlation with outcome in a cohort of COVID-19 patients.
Methods: The EEGs recorded during the first year of the COVID-19 pandemic were retrospectively evaluated to identify the main pattern and focus on the occurrence of a low-voltage background, either attenuated (10-20 μV) or suppressed (< 10 μV). We sought a correlation between in-hospital mortality and low-voltage EEG. In a subsample of patients, biomarkers of inflammation, hypoxemia and organ failure were collected. Brain imaging was also evaluated.
Results: Among 98 EEG performed in 50 consecutive patients, diffuse unreactive slowing was the most prevalent pattern (54%), followed by unreactive attenuation or suppression pattern (26%), being the latter significantly correlated with an unfavourable outcome (p = 0.0004). Survivors showed significantly lower interleukine-6 values compared to non-survivors. Patients with attenuated EEG and non-survivors also showed lower PaO 2 /FiO 2 values. Neuroradiological findings were very heterogeneous with a prevalence of lesions suggestive of a microangiopathic substrate.
Conclusions: EEG attenuation or suppression may be more frequent than previously reported and significantly associated with a poor outcome. SARS-CoV-2 infection may result in encephalopathy and reduced EEG voltage through mechanisms that are still unknown but deserve attention given its negative impact on prognosis.
Keywords: EEG attenuation; EEG background; EEG suppression; Encephalopathy; Hypoxemia; Outcome; SARS-CoV-2.
【저자키워드】 outcome, SARS-CoV-2., Hypoxemia, Encephalopathy, EEG suppression, EEG background, EEG attenuation, 【초록키워드】 SARS-CoV-2, Prognosis, SARS-COV-2 infection, COVID-19 pandemic, Prevalence, Cohort, correlation, patients, mechanism, in-hospital mortality, COVID-19 patients, EEG, Organ failure, Brain imaging, lesion, Non-survivors, consecutive patients, heterogeneous, significantly lower, non-survivor, prevalent, Occurrence, identify, performed, collected, significantly, reported, evaluated, reduced, correlated, suppressed, recorded, biomarkers of inflammation, brain involvement, epileptiform, PaO, 【제목키워드】 COVID-19 patient,