A study of Electroencephalography Findings and its Prognostic Value in Severe COVID-19 Patients Admitted at Intensive Care Unit

Fawad Ahmad; Wasim Alamgir; Imran Ahmad; Saima Shafait; Anusha Pervaiz; Zahid Farooq Baig

doi:10.51253/pafmj.v74i2.7446

Authors

Fawad Ahmad Department of Neurology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Wasim Alamgir epartment of General Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Imran Ahmad Department of Neurology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Saima Shafait Department of Neurology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Anusha Pervaiz Department of Neurology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Zahid Farooq Baig Department of Medicine, Combined Military Hospital, Lahore/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i2.7446

Keywords:

COVID-19, Electroencephalography, Encephalopathy, Electroencephalogram (EEG), Richmond Agitation-Sedation Scale

Abstract

Objective: To study electroencephalography patterns in COVID-19 patients admitted to intensive care unit and find the association of these patterns with outcome.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Intensive Care Unit, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Nov 2020 to Mar 2021.

Methodology: Eighteen electroencephalograms in COVID-19 patients with Encephalopathy were recorded using a 10-20 electrode system. The duration of each recording was 30 minutes. Traces were analysed by a neurologist for delta slowing, epileptiform discharges, and posterior dominant rhythm. Generalised slowing was classified as mild (background slowing), moderate (intermittent slowing) and severe (continuous slowing).

Results: A total of 18 COVID-19 patients, with a mean age of 63±16.02 years, underwent electroencephalography recording of 30 min duration. Diabetes mellitus and ischemic heart disease were the most common co-morbidity (7, 38.9%), followed by CKD. Non-specific generalised slowing was observed in all EEGs. No epileptiform discharges or focality were seen. Posterior Dominant Rhythm has been related to a good outcome. At the same time, severe Encephalopathy (Richmond Agitation-Sedation Scale of -3 to -5) was associated with poor outcomes (p-value<0.05).

Conclusion: Patients with Posterior Dominant Rhythm had more chances of having good outcomes, while patients with severe encephalopathy findings on EEG were more at risk of poor outcomes.

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Author Biographies

Imran Ahmad, Department of Neurology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Saima Shafait, Department of Neurology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Anusha Pervaiz, Department of Neurology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Zahid Farooq Baig, Department of Medicine, Combined Military Hospital, Lahore/National University of Medical Sciences (NUMS) Pakistan

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