Health consequences and daily life modifications in children and adolescents with epilepsy during the COVID-19 pandemic - a systematic review

• Published in: Seizure (London, England) Vol. 108; pp. 102 - 115
• Main Authors: Dal-Pai, Janise, Dos Santos, Michele Paula, Donida, Natalie da Silveira, Cesarino, Matheus Ribeiro, de Oliveira, Victor Hugo Midões Santana, Nunes, Magda Lahorgue
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.05.2023
• ISSN: 1059-1311; 1532-2688
• DOI: 10.1016/j.seizure.2023.04.017

•In this study, we aimed to review health consequences of COVID 19 pandemic to children and adolescents with epilepsy.•Some studies showed increase of seizures frequency.•Parents/caregivers struggled with difficulties to access anti-seizure medications and to schedule reviews in outpatients’ clinics.•Children/adolescents had problems with distance learning and spent more time in the use of electronic devices.•Increase in behavioral and sleep problems were reported.•When available telemedicine was very useful. Purpose: To describe the impact of the COVID-19 pandemic on the health care and daily life of children and adolescents with epilepsy. Methods: This systematic review followed the preferred reporting items guidelines and was registered on the PROSPERO platform (CRD42021255931). The PECO (Patient, Exposure, Comparison, Outcome) framework criteria were as follows: people with epilepsy (0–18 years old); exposed to the COVID-19 pandemic; and outcomes, including epilepsy type, time of clinical diagnosis, seizure exacerbation, treatment and medications, need for emergency because of seizures, sleep, behavior, comorbidities and/or concerns, social and/or economic impact, insurance status, electronic device use, telemedicine, and distance learning. Literature searches for cross-sectional and longitudinal studies were conducted on Embase and PubMed. The methodological quality of identified studies was assessed using the Newcastle‒Ottawa Scale (NOS). Results: Data were extracted from 23 eligible out of 597 identified articles and included 31,673 patients. The mean NOS scores for cross-sectional study design was 3.84/10, and for longitudinal, it was 3.5/8 stars. Seizure exacerbations were reported in three studies, difficulties with access to anti-seizure medications in two, changes in dosage in five, and visit postponed or cancelation in five studies. Problems with sleep were highlighted in three, issues related to distance learning in two, an increased time spent on electronic devices in three, and increased behavioral problems in eight studies. Telemedicine, when available, was described as useful and supporting patient's needs. Conclusion: The pandemic affected the health care and lifestyle of young individuals with epilepsy. The main problems described revolved around seizure control, accessing anti-seizure medication, sleep and behavioral complains. [Display omitted]