article · The Egyptian Journal of Neurology Psychiatry and Neurosurgery
Abstract Background COVID-19 is known to affect multiple organ systems, including the brain, leading to neurological complications such as seizures, encephalopathy, and cognitive dysfunction. However, its impact on brain electrical activity remains unclear. Electroencephalography (EEG) is a valuable tool for detecting brain dysfunction, particularly in critically ill patients. Methods A case-control study was conducted involving 95 patients presenting with respiratory symptoms suggestive of recent COVID-19 infection. Participants were classified into two groups: the COVID-19 group (study group) ( n = 49), consisting of patients with a confirmed diagnosis of COVID-19 based on RT-PCR testing and chest CT findings, and the non-COVID-19 control group ( n = 46), comprising patients with similar clinical symptoms but negative COVID-19 test results. All patients underwent comprehensive neurological examinations and continuous electroencephalogram (EEG) monitoring for six hours at two time points: within 24 h of hospital admission and following clinical improvement prior to discharge. Results EEG abnormalities were observed in 51.0% of patients in the COVID-19 group, significantly higher than the 28.3% observed in the non-COVID-19 group ( p < 0.05). The most frequent EEG findings included generalized slowing, focal slowing, and rhythmic delta activity. Patients exhibiting EEG abnormalities experienced significantly longer hospital stays compared to those with normal EEG results (average 20.4 vs. 10.5 days, p < 0.05). However, no significant association was found between EEG abnormalities and the severity of pulmonary involvement ( p > 0.05). Conclusion COVID-19 is associated with EEG abnormalities, particularly diffuse slowing and rhythmic delta activity, which may indicate brain dysfunction. EEG could be a useful tool for monitoring neurological involvement in COVID-19, especially in patients with persistent symptoms.
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DOI: 10.1186/s41983-026-01120-5
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