People with epilepsy: increased risk of severe COVID-19

Published: November 30 2020
Last updated: September 28 2022

There is a slightly increased risk of hospital admission and death from COVID-19 in people with epilepsy, according to a new study in the British Medical Journal (BMJ).

The research, published in October 2020, looked at risk factors for hospital admissions and death from COVID-19 in 6.08 million adults across England. The data were collected between 24 January and 30 April.

Among the risk factors, were conditions for which people are advised to shield, and conditions moderately associated with increased risk of complications from COVID-19, according to current NHS guidance.

The evidence from the research by Clift and colleagues showed a small increase in risk of hospital admissions and deaths resulting from COVID-19 in both men and women with epilepsy. The risk appears to be slightly higher still in men than in women.

Among the highest risk factors were conditions like Down’s syndrome and sickle cell disease or severe immunodeficiency, as well as treatments like higher grade chemotherapy.

Until now, there was no evidence to suggest people with epilepsy were at an increased risk of more severe symptoms of COVID-19.

A FAIR Health White Paper published in November 2020 looked at risk factors for death from COVID-19 among privately insured patients in the US. The findings of this paper are in line with the BMJ study when it comes to epilepsy – it identified a slightly increased risk.

Dr Markus Reuber, professor of Clinical Neurology at the University of Sheffield, said: “Epilepsy emerges as a factor associated with a slightly higher risk of death or of hospital admission due to COVID-19 in this dataset. This does not mean that epilepsy is the cause of this higher risk.”

Dr Reuber explained that a diagnosis of epilepsy could be a marker of other features more directly linked to the risk of more severe COVID-19 infection. These could include more contact with professional carers, attendance of educational settings and other conditions linked to or causing the epilepsy.

He added: “This study raises the concern that people with epilepsy could be at slightly greater risk of hospitalisation during or shortly after a COVID infection, and that they could be at increased risk of death in these circumstances. This study does not prove a link between hospitalisation or death and epilepsy.”

Dr Rhys Thomas, consultant neurologist at the Newcastle upon Tyne Hospitals NHS Foundation Trust, said: “Population data have identified health features that increase the risk for COVID-19 severity. It is unclear how this contributes to an individual’s risk. People with an intellectual disability appear to be at a greater risk of COVID19 severity, and to a much lesser extent the same appears to be the case for people with epilepsy.

“This risk is not sufficient to ask people with epilepsy to strictly shield, or to identify themselves as highly vulnerable. But it further emphasises the need for all of us to keep up our efforts to wear face-masks, keep our distance from others and wash our hands as advised.”

Dr Reuber also pointed out that further social withdrawal could be harmful for some people with epilepsy, especially in people already facing stigma or social exclusion.

The full BMJ study is available online.

There is more information about epilepsy and COVID-19 on the Epilepsy Action website.