Dados do Trabalho

Título

Epilepsy in children and adolescents in the COVID-19 pandemic, health consequences - a systematic review

Introdução

The COVID-19 pandemic has reduced the access of children and adolescents with epilepsy to specialized treatment and to other services, impacting patient's health.

Objetivo

The aim of this study was to verify, through a systematic review (SR) of the literature, the consequences of the COVID-19 pandemic on the health of children and adolescents with epilepsy.

Método

To this end, this RS followed the PRISMA guide and was registered on the PROSPERO platform- CRD42021255931. PICO implemented was: patients with epilepsy between 0 and 18 years of age; exposed to the COVID-19 pandemic; and the outcomes: seizure exacerbation, behavior, comorbidities, access to emergency department, distance learning, sleep, concerns and/or difficulties during pandemic, use of electronic devices, treatment and medicine. Cross-sectional and longitudinal studies from Lilacs, Embase and PubMed databases were included. Methodological quality was assessed using two adapted versions of the Newcastle-Ottawa Scale (NOS). Fifteen eligible articles out of 272 identified had the data extracted. The mean NOS score for the cross-sectional (n: 8) was 4.02 stars (2-6) and for longitudinal (n: 7), 2.9 (0-6).

Resultados

Seizure exacerbation (n: 6 articles) affected 2.6 – 28% of patients, 4 papers observed worsening in patient's behavior, while 2 correlated with changes in seizures’ frequency. In comorbidities (n: 6), 41.7% of children that had developed any infection, 17.2% had COVID-19 confirmed. The access to the emergency department due to seizures (n: 4) was heterogeneous, showing increase and decrease among articles. In distance learning (n: 3), 39 - 82% of patients needed parents' support. Worsening in sleep (n: 4) affected 30 to 51% of patients and was related to seizure frequency. Concerns of patients/parents (n: 8) were medical appointments canceled and the impact of pandemic in children's health. Electronic devices use (n: 4) increased 93%, with negative correlation with seizures. Antiseizure medication (n: 11), had increased in dose and in the number of drugs taken, as well difficulty in its obtention.

Conclusão

In this SR we have identified that the pandemic has brought negative consequences to this population, whose repercussions are already perceived, and others might be observed in the coming years. The identified outcomes may help pediatricians and other professionals in the development of strategies to patient’s treatment.

Palavras-chave

Epilepsy; Pandemic; coronavirus disease 2019; children and teenagers