Did the COVID-19 pandemic impact help-seeking behavior for seizure management? A Google Trends™ study.

Google Trends™ is a popular tool for analyzing healthcare-seeking patterns based on observed changes in the relative search volume (RSV) of the queries made on the Google™ search engine. Google Trends™ was increasingly utilized during the pandemic to assess the impact on mental health, risk communication, the impact of media coverage, and preparedness prediction. The objective of this study was to evaluate the impact of the Coronavirus disease 2019 (COVID-19) pandemic on help-seeking behaviors for seizures and/or epilepsy by assessing the changes in seizure-related online queries in periods before and since the advent of the COVID-19 pandemic on Google Trends™. We compared the RSV volumes in the year prior to and during the COVID-19 pandemic against weekly COVID-19 positive cases for each state and US census regions Search terms were categorized according to seizure symptoms or seizure treatment. Our study showed no significant increase in the RSV for seizure and epilepsy-related searches during the COVID-19 pandemic via Google Trends™. Public health entities and medical systems may use Google Trends ™ as a way to predict national, regional, and local patient needs and drive resources to meet patient demands.

Outcomes of seizures, status epilepticus, and EEG findings in critically ill patient with COVID-19.

OBJECTIVE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has a myriad of neurological manifestations and its effects on the nervous system are increasingly recognized. Seizures and status epilepticus (SE) are reported in the novel coronavirus disease (COVID-19), both new onset and worsening of existing epilepsy; however, the exact prevalence is still unknown. The primary aim of this study was to correlate the presence of seizures, status epilepticus, and specific critical care EEG patterns with patient functional outcomes in those with COVID-19. METHODS: This is a retrospective, multicenter cohort of COVID-19-positive patients in Southeast Michigan who underwent electroencephalography (EEG) from March 12th through May 15th, 2020. All patients had confirmed nasopharyngeal PCR for COVID-19. EEG patterns were characterized per 2012 ACNS critical care EEG terminology. Clinical and demographic variables were collected by medical chart review. Outcomes were divided into recovered, recovered with disability, or deceased. RESULTS: Out of the total of 4100 patients hospitalized with COVID-19, 110 patients (2.68%) had EEG during their hospitalization; 64% were male, 67% were African American with mean age of 63 years (range 20-87). The majority (70%) had severe COVID-19, were intubated, or had multi-organ failure. The median length of hospitalization was 26.5 days (IQR = 15 to 44 days). During hospitalization, of the patients who had EEG, 21.8% had new-onset seizure including 7% with status epilepticus, majority (87.5%) with no prior epilepsy. Forty-nine (45%) patients died in the hospital, 46 (42%) recovered but maintained a disability and 15 (14%) recovered without a disability. The EEG findings associated with outcomes were background slowing/attenuation (recovered 60% vs recovered/disabled 96% vs died 96%, p < 0.001) and normal (recovered 27% vs recovered/disabled 0% vs died 1%, p < 0.001). However, these findings were no longer significant after adjusting for severity of COVID-19. CONCLUSION: In this large multicenter study from Southeast Michigan, one of the early COVID-19 epicenters in the US, none of the EEG findings were significantly correlated with outcomes in critically ill COVID-19 patients. Although seizures and status epilepticus could be encountered in COVID-19, the occurrence did not correlate with the patients' functional outcome.