ORIGINAL RESEARCH article
Front. Neurol.
Sec. Epilepsy
Clinical characteristics and long-term treatment outcomes of patients with new-onset epileptic seizures associated with COVID-19 infection
Fang Li 1
Ling-Qi Ye 2
Yuyu Yang 1
Wenjie Ming 1
Shuang Wang 1
Zhongjin Wang 1
1. Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
2. Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
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Abstract
Background: This study investigates the clinical characteristics and approximately two-year treatment outcomes of patients with new-onset epileptic seizures during the acute phase of COVID-19 infection. Methods: A retrospective, single-center cohort study was conducted from December 2022 to June 2023. The patients were categorized into two groups: those with acute encephalopathy (Group 1) and those without (Group 2). Results: This study enrolled a total of 34 patients (15 male and 19 female), with 18 assigned to Group 1 and 16 to Group 2. Patients in Group 2 (median: 32.5 years) were significantly younger than those in Group 1 (median: 60 years; p < 0.05). Status epilepticus was more frequent in Group 1 (66.7%, 12/18) compared to Group 2 (6.3%, 1/16; p < 0.001). Seizure latency was significantly shorter in Group 1 (median: 2 days) than in Group 2 (median: 9 days; p < 0.001). Abnormal posterior background activity on EEG was observed in 57.1% of Group 1 patients (4/7, p < 0.05), but in none of the Group 2 patients. However, a higher proportion of Group 2 patients showed interictal epileptiform discharges (72.7%, 8/11) compared to Group 1 (28.6%, 2/7). Epilepsy-related MRI abnormalities appeared in 22.2% (4/18) of Group 1 and 31.3% (5/16) of Group 2 patients. The proportion diagnosed with epilepsy was significantly higher in Group 2 compared to Group 1 (87.5% vs. 22.2%, p < 0.05). After 25 months of follow-up, one patient from each group developed drug-resistant epilepsy. Conclusions: New-onset epileptic seizures associated with COVID-19 generally have a favorable prognosis. A lower proportion of patients developed drug-resistant epilepsy.
Summary
Keywords
Anti-seizure medications, COVID-19, Epilepsy, Seizures, Treatment outcomes
Received
01 December 2025
Accepted
20 February 2026
Copyright
© 2026 Li, Ye, Yang, Ming, Wang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Zhongjin Wang
Disclaimer
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