Can an EEG Detect COVID-19?

An analysis of EEG data from novel coronavirus patients, published in the French journal Neurophysiologie Clinique, could not find any patterns that could be linked specifically to COVID-19 – but more research like this was deemed necessary.

In the early months of the COVID-19 pandemic, EEG technologists were among a group of healthcare workers making the news because they were actually working less while ERs, ICUs, and respiratory care personnel were stretched beyond capacity.

Evidence linking the coronavirus to neurological complications – such as change in consciousness, stroke, and encephalopathy – began to slowly build. It was accompanied by an increase in research looking at just how the virus impacts the brain.

Professionals working with patients positive for COVID-19 began to notice some neurological problems like confusion, possible seizures, and a slowness to wake from anesthesia. That’s when EEG techs were asked to garb up in full PPE and perform EEGs. ASET- The Neurodiagnostic Society and other professional groups quickly put out safety guidelines for techs working with COVID-19 positive patients.

Fast forward several months and evidence is emerging that there is a link between the coronavirus and neurological disease. This has meant deploying more neuro professionals and performing more neurological tests, including electroencephalograms (EEG).

Just how the virus affects the brain is still in question. Researchers in the neurophysiology unit in Bicêtre University Hospital in France decided to comb through all the EEG data taken from patients positive for COVID-19 since the start of the pandemic. They wanted to see if there were any specific EEG patterns that could be linked to the virus.

Between March and June, 2020, 44 EEGs were performed on 40 patients at this hospital. They ultimately analyzed the results of 40 EEGs on 36 of those patients, some in the ICU and some in the medical unit. All patients had been admitted to the hospital for acute respiratory distress syndrome. All had good indications for EEG testing, including confusion and fluctuating awareness, suspected epileptic seizures. Some didn’t awaken after sedation was stopped.

Techs performed each of these EEGs over 20 minutes, using the International 10-20 system for the placement of scalp electrodes.

Patients were stimulated by verbal commands, eye opening and, if still no arousals were noted, by sternal rub or nailbed compression, according to the authors. Two neurologists independently reviewed the data, and they used the American Neurophysiology Society’s standardized terminology.

More than half of the EEGs performed came out normal or only mildly altered. The rest were categorized as moderate to critical, with 13 recordings showing “generalized periodic discharges (GPDs), multifocal periodic discharges (MPDs) or rhythmic delta activity (RDA).”

The abnormal findings, reported the authors, were consistent with their underlying neurological disease manifestations. They did not, however, show any patterns that could be linked specifically to COVID-19.

“EEG alterations were not different from those encountered in other pathological conditions,” they concluded.

This study was small and the first of its kind, so the results should be considered preliminary when it comes to linking EEG changes and COVID-19. While more research is necessary, it is clear that COVID-19 does have an impact on the nervous system and those who work in neuro will have an increasingly important role to play in the coming months.

Another notable outcome of the research? The acknowledgement section of this COVID-19 paper opens with, “We are indebted to the EEG technologists.”

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