Objectives: We explored the impact of the coronavirus disease-19 (COVID-19) emergency on the health of people with epilepsy (PwE) We also investigated their attitude toward telemedicine Methods: The PubMed database up to September 10, 2020 was searched for questionnaire-based studies conducted in PwE during the COVID-19 emergency, and the literature retrieved was reviewed In addition, all patients who had a telephone consultation with our center between May 7 and July 31, 2020 were invited to fill in a 57-item online questionnaire focusing on epilepsy and comorbidities, any changes in lifestyle or clinical conditions and any emergency-related problems arising during the COVID-19 emergency, and their views on telemedicine Associations between variables were detected through X (2) test and Fisher's exact test Univariate and multivariate logistic regression models were used to evaluate the effects of different factors on clinical conditions Results: Twelve studies met the literature search criteria They showed that the rate of seizure worsening during the emergency ranged from 4 to 35% and was mainly correlated with epilepsy severity, sleep disturbances and COVID-19-related issues Our questionnaire was filled in by 222 PwE or caregivers One hundred (76 6%) reported unchanged clinical conditions, 25 (11 3%) an improvement, and 27 (12%) a deterioration Reported clinical worsening was associated with a psychiatric condition and/or medication (OR = 12 59, p &lt; 0 001), sleep disorders (OR = 8 41, p = 0 001), limited access to healthcare (OR = 4 71, p = 0 016), and experiencing seizures during the emergency (OR = 4 51, p = 0 007) Telemedicine was considered acceptable by 116 subjects (52 3%) Conclusions: Most PwE did not experience a significant change in their clinical conditions during the COVID-19 emergency However, severity of epilepsy, concomitant disability, comorbid psychiatric conditions, sleep disorders and limited access to healthcare may affect their health
The Impact of the COVID-19 Pandemic on People With Epilepsy. An Italian Survey and a Global Perspective