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Clinical outcomes of COVID-19 in long-term care facilities for people with epilepsy.

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ICR Author
Hubank, Michael
Author
Balestrini, S
Koepp, MJ
Gandhi, S
Rickman, HM
Shin, GY
Houlihan, CF
Anders-Cannon, J
Silvennoinen, K
Xiao, F
Zagaglia, S
Hudgell, K
Ziomek, M
Haimes, P
Sampson, A
Parker, A
Helen Cross, J
Pardington, R
Nastouli, E
Swanton, C
Crick COVID Consortium (CCC)
Sander, JW
Sisodiya, SM
ChAlfont keepS vulnerAble People safe (ASAP) Consortium:
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Type
Journal Article
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Abstract
In this cohort study, we aim to compare outcomes from coronavirus disease 2019 (COVID-19) in people with severe epilepsy and other co-morbidities living in long-term care facilities which all implemented early preventative measures, but different levels of surveillance. During 25-week observation period (16 March-6 September 2020), we included 404 residents (118 children), and 1643 caregivers. We compare strategies for infection prevention, control, and containment, and related outcomes, across four UK long-term care facilities. Strategies included early on-site enhancement of preventative and infection control measures, early identification and isolation of symptomatic cases, contact tracing, mass surveillance of asymptomatic cases and contacts. We measured infection rate among vulnerable people living in the facilities and their caregivers, with asymptomatic and symptomatic cases, including fatality rate. We report 38 individuals (17 residents) who tested severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive, with outbreaks amongst residents in two facilities. At Chalfont Centre for Epilepsy (CCE), 10/98 residents tested positive: two symptomatic (one died), eight asymptomatic on weekly enhanced surveillance; 2/275 caregivers tested positive: one symptomatic, one asymptomatic. At St Elizabeth's (STE), 7/146 residents tested positive: four symptomatic (one died), one positive during hospital admission for symptoms unrelated to COVID-19, two asymptomatic on one-off testing of all 146 residents; 106/601 symptomatic caregivers were tested, 13 positive. In addition, during two cycles of systematically testing all asymptomatic carers, four tested positive. At The Meath (TM), 8/80 residents were symptomatic but none tested; 26/250 caregivers were tested, two positive. At Young Epilepsy (YE), 8/80 children were tested, all negative; 22/517 caregivers were tested, one positive. Infection outbreaks in long-term care facilities for vulnerable people with epilepsy can be quickly contained, but only if asymptomatic individuals are identified through enhanced surveillance at resident and caregiver level. We observed a low rate of morbidity and mortality, which confirmed that preventative measures with isolation of suspected and confirmed COVID-19 residents can reduce resident-to-resident and resident-to-caregiver transmission. Children and young adults appear to have lower infection rates. Even in people with epilepsy and multiple co-morbidities, we observed a high percentage of asymptomatic people suggesting that epilepsy-related factors (anti-seizure medications and seizures) do not necessarily lead to poor outcomes.
URI
https://repository.icr.ac.uk/handle/internal/4434
DOI
https://doi.org/10.1016/j.yebeh.2020.107602
Collections
  • Molecular Pathology
Subject
Crick COVID Consortium (CCC)
ChAlfont keepS vulnerAble People safe (ASAP) Consortium:
Humans
Epilepsy
Treatment Outcome
Long-Term Care
Cohort Studies
Comorbidity
Infection Control
Adult
Aged
Aged, 80 and over
Middle Aged
Residential Facilities
Female
Male
Young Adult
United Kingdom
COVID-19
Research team
Translational Genomics
Translational Genomics
Language
eng
Date accepted
2020-10-24
Citation
Epilepsy & behavior : E&B, 2021, 115 pp. 107602 - ?

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