Table 2.
Factors associated with seizure worsening during COVID-19 period (n = 461).
| Factors | Seizure worsening during COVID-19 |
p-value | ||
|---|---|---|---|---|
| Yes (n = 60), n (%) | No (n = 400), n (%) | |||
| Sociodemographic Characteristics | ||||
| Age (Years), Mean ± SD | 37.18 ± 15.79 | 39.51 ± 15.91 | NS | |
| Gender |
Male (n = 230) | 30 (13.0) | 200 (87.0) | NS |
| Female (n = 231) | 30 (13.0) | 201 (87.0) | ||
| Race | Malay (n = 139) | 21 (35.0) | 118 (29.3) | NS |
| Chinese (n = 208) | 25 (41.7) | 183 (45.8) | ||
| Indian (n = 103) | 11 (18.3) | 92 (23.0) | ||
| Native (n = 1) | 1 (1.7) | 1 (0.3) | ||
| Others (n = 7) | 2 (3.3) | 7 (1.8) | ||
| Marital Status | Single (n = 265) | 38 (14.3) | 227 (85.7) | NS |
| Others (n = 196) | 22 (11.2) | 174 (88.8) | ||
| Education | Secondary or below (n = 256) | 36 (14.1) | 220 (85.9) | NS |
| Tertiary (n = 205) | 24 (11.7) | 181 (88.3) | ||
| Employment | Employed (n = 183) | 20 (10.9) | 163 (89.1) | NS |
| Others (n = 278) | 25 (16.6) | 126 (83.4) | ||
| Clinical characteristics | ||||
| Age of onset (Years), Mean ± SD | 17.78 ± 14.00 | 21.34 ± 15.93 | NS | |
| Seizure frequency before COVID-19 | No seizure for at least a year (n = 173) | 4 (2.3) | 169 (97.7) | 0.000 |
| Less than once a month (n = 166) | 17 (10.2) | 149 (89.8) | ||
| One of more seizure a month (n = 122) | 39 (32.0) | 83 (68.0) | ||
| Seizure type | Focal (n = 249) | 39 (15.7) | 210 (84.3) | NS |
| Others (n = 212) | 21 (9.9) | 191 (90.1) | ||
| EEG | Abnormal (n = 310) | 46 (14.8) | 264 (85.2) | NS |
| Others (n = 151) | 14 (9.3) | 137 (90.7) | ||
| Imaging | Abnormal (n = 254) | 33 (13.0) | 221 (87.0) | NS |
| Others (n = 207 | 27 (13.0) | 180 (87.0) | ||
| No. of AEDs | 1 (n = 144) | 12 (8.3) | 132 (91.7) | 0.000 |
| 2 (n = 127) | 8 (6.3) | 119 (93.7) | ||
| 3 or more (n = 190) | 40 (21.1) | 150 (78.9) | ||
| Surgery | Yes (n = 57) | 6 (10.5) | 51 (89.5) | NS |
| Others (n = 404) | 54 (13.4) | 350 (86.6) | ||
| Hospital | UMMC (n = 420) | 48 (11.4) | 372 (88.6) | 0.003 |
| Others (n = 41) | 12 (29.3) | 29 (70.7) | ||
| Triggers | ||||
| Reason for seizure worsening | Stress (n = 107) | 25 (23.4) | 82 (76.6) | 0.001 |
| Inadequate sleep (n = 125) | 28 (22.4) | 97 (77.6) | 0.000 | |
| Missed AEDs (n = 62) | 5 (8.1) | 57 (91.9) | NS | |
| Inadequate AEDs (n = 10) | 3 (30.0) | 7 (70.0) | NS | |
| Fever (n = 24) | 2 (8.3) | 22 (91.7) | NS | |
| Physical tiredness (n = 86) | 16 (18.6) | 70 (81.4) | NS | |
| Diet (n = 23) | 4 (17.4) | 19 (82.6) | NS | |
| Clinic Appointment | ||||
| Difficulty to reschedule clinic appointments | Yes (n = 120) | 21 (17.5) | 99 (82.5) | NS |
| No (n = 182) | 19 (10.4) | 163 (89.6) | ||
| Worries seizures get worse because of postponed clinic appointments | Yes (n = 139) | 25 (18.0) | 114 (82.0) | 0.001 |
| No (n = 322) | 35 (10.9) | 287 (89.1) | ||
| Access to online or tele-consultation | Yes (n = 341) | 20 (16.7) | 100 (83.3) | NS |
| No (n = 120) | 40 (11.7) | 301 (88.3) | ||
| Emergency unit | ||||
| Afraid to go to emergency unit | Yes (n = 133) | 19 (14.3) | 114 (85.7) | NS |
| No (n = 211) | 22 (10.4) | 189 (89.6) | ||
| Difficulty to go to emergency unit | Yes (n = 86) | 21 (24.4) | 65 (75.6) | 0.000 |
| No (n = 375) | 39 (10.4) | 336 (89.6) | ||
| Understand need to go to emergency unit | Yes (n = 372) | 47 (12.6) | 325 (87.4) | NS |
| No (n = 89) | 13 (14.6) | 76 (85.4) | ||
| Knowledge on what to do during seizures | Yes (n = 363) | 47 (12.9) | 316 (87.1) | NS |
| No (n = 98) | 13 (13.3) | 85 (86.7) | ||
| Medication Supply | ||||
| Pay for your own AEDs | Yes, fully (n = 191) | 23 (12.0) | 168 (88.0) | NS |
| Yes, partially (n = 187) | 21 (11.2) | 166 (88.8) | ||
| No, fully subsidized (n = 83) | 16 (19.3) | 67 (80.7) | ||
| Difficult to get AEDs | Yes (n = 112) | 20 (17.9) | 92 (82.1) | NS |
| No (n = 224) | 24 (10.7) | 200 (89.3) | ||
| Difficult to arrange AED delivery | Yes (n = 123) | 21 (17.1) | 102 (82.9) | NS |
| No (n = 172) | 19 (11.0) | 153 (89.0) | ||
| Difficult to arrange self-pick-up | Yes (n = 91) | 18 (19.8) | 328 (88.6) | 0.016 |
| No (n = 370) | 42 (11.4) | 138 (91.4) | ||
| AEDs ran out of stock | Yes (n = 56) | 13 (23.2) | 43 (76.8) | 0.037 |
| Others (n = 405) | 47 (11.6) | 358 (88.4) | ||
| Insufficient AED supply | Yes (n = 53) | 8 (15.1) | 45 (84.9) | NS |
| No (n = 320) | 41 (12.8) | 279 (87.2) | ||
| Skipped AEDs | Yes (n = 66) | 12 (18.2) | 54 (81.8) | NS |
| Others (n = 395) | 48 (12.2) | 347 (87.8) | ||
| Self-adjusted AED dosage | Yes (n = 53) | 14 (26.4) | 39 (73.6) | 0.004 |
| Others (n = 408) | 46 (11.3) | 362 (88.7) | ||
| Psychological Scales | ||||
| Mean ± SD | ||||
| HADS | Anxiety score | 8.10 ± 5.011 | 4.84 ± 3.99 | 0.000 |
| Depression score | 6.05 ± 3.87 | 3.86 ± 3.59 | 0.000 | |
| QOLIE −31 | Overall Score | 48.01 ± 13.04 | 62.15 ± 15.22 | 0.000 |
|
29.72 ± 23.71 | 49.17 ± 27.45 | 0.000 | |
|
56.25 ± 16.26 | 69.72 ± 17.47 | 0.000 | |
|
56.07 ± 17.04 | 66.76 ± 17.38 | 0.000 | |
|
44.42 ± 14.99 | 59.36 ± 17.22 | 0.000 | |
|
47.71 ± 21.87 | 61.12 ± 22.74 | 0.000 | |
|
52.26 ± 11.78 | 54.35 ± 12.96 | NS | |
|
45.55 ± 20.19 | 62.68 ± 22.65 | 0.000 | |
NS, Not significant; *UMMC, University Malaya Medical Centre.