LitCovid-sentences  

PMC:7502678 / 1508-25891 JSONTXT 14 Projects

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Id Subject Object Predicate Lexical cue
T14 0-141 Sentence denotes The corona virus infectious disease-2019 (COVID-19) pandemic has had an exceptional impact on delivery of care to people with epilepsy (PWE).
T15 142-237 Sentence denotes In addition to obviously impacting PWE, the pandemic has also affected epilepsy care providers.
T16 238-447 Sentence denotes In mid-April, 2020, the American Epilepsy Society (AES) determined that a membership survey should be conducted to better understand the effects of the COVID-19 pandemic on members and the patients they serve.
T17 448-664 Sentence denotes The Quantitative Practical Use-Driven Learning Survey in Epilepsy (Q-PULSE) Taskforce was charged with creating a survey that would assess how the most important aspects of epilepsy care delivery were being affected.
T18 665-867 Sentence denotes Unlike typical Q-PULSE surveys that are sent only to National Association of Epilepsy Center directors, this survey was sent to all AES members, as it was intended to reflect broad practice experiences.
T19 868-973 Sentence denotes The survey was sent in late April 2020, and several emails were sent to encourage members to complete it.
T20 974-1178 Sentence denotes The survey was open April 30 to June 14, 2020 The survey was publicized by AES to members through 3 e-blasts, several AES Connections e-newsletter items, AES Connect forum, and various social media posts.
T21 1179-1335 Sentence denotes The survey did not specifically screen for AES membership, and electronic publicity distribution meant that non-AES members may have been among respondents.
T22 1336-1440 Sentence denotes The initial survey questions did screen out respondents who were not directly involved in clinical care.
T23 1441-1600 Sentence denotes Of the 4193 average distribution for the 3 e-blasts, an average of 1448 (34%) opened each message, and a total of 434 recipients clicked through to the survey.
T24 1601-1720 Sentence denotes Overall, a total of 366 members responded to the survey (response rate of 9% of the total member e-blast distribution).
T25 1721-1876 Sentence denotes Of the 366 total initial respondents, 29 did not complete the survey (21 not directly involved in patient care and 8 completed only demographic questions).
T26 1877-1961 Sentence denotes A total of 337 respondents completed some portion of the remaining survey questions.
T27 1962-2043 Sentence denotes Because responses were not required, not all respondents completed all questions.
T28 2044-2133 Sentence denotes The AES Guidelines and Assessment Committee (GAC) was charged with analyzing the results.
T29 2134-2255 Sentence denotes A volunteer group of members of the GAC and a few members of the Q-PULSE Work Group summarized the results of the survey.
T30 2256-2369 Sentence denotes The results are divided into 4 parts: demographics, patient care issues, practice-related issues, and telehealth.
T31 2370-2495 Sentence denotes Because of its importance in the current pandemic, telehealth questions were separated from other practice-related questions.
T32 2496-2586 Sentence denotes Several questions were open ended, and the information from the survey is summarized here.
T33 2587-2650 Sentence denotes A PDF of the survey questions is provided in Online Appendix 1.
T34 2651-2768 Sentence denotes It is important to appreciate that the results presented are a snapshot of member practice and not clinical guidance.
T35 2770-2782 Sentence denotes Demographics
T36 2783-2824 Sentence denotes There were 337 respondents to the survey.
T37 2825-2875 Sentence denotes The majority of respondents (79%) were physicians.
T38 2876-3026 Sentence denotes Medical trainees constituted 7% of the respondents, while 5% were advanced practice providers, and 3% were electroencephalography (EEG) technologists.
T39 3027-3105 Sentence denotes Most respondents were from the United States (80%), while 7% were from Europe.
T40 3106-3187 Sentence denotes The rest, about 4% each, were from South America, Asia, and non-US North America.
T41 3188-3367 Sentence denotes Respondents were asked how they would describe the degree of community spread of COVID-19 cases in their region using subjective terms (no reported cases, mild, moderate, severe).
T42 3368-3613 Sentence denotes At the time the survey was conducted, one-half (50%) described their geographic region (American state or country) as “moderately” affected by the COVID-19 pandemic, while a quarter each described their region as “severely” or “mildly” affected.
T43 3614-3691 Sentence denotes Only one respondent was not aware of COVID-19 cases in their area (Figure 1).
T44 3692-3701 Sentence denotes Figure 1.
T45 3703-3735 Sentence denotes Concentration of COVID-19 cases.
T46 3737-3759 Sentence denotes Impact on Patient Care
T47 3761-3782 Sentence denotes Seizures and COVID-19
T48 3783-3900 Sentence denotes About a third (30%) of the survey respondents reported a suspected cause for new onset seizures in COVID-19 patients.
T49 3901-4029 Sentence denotes Most often the mechanism thought to be responsible for the seizures was lowered seizure threshold with preexisting risk factors.
T50 4030-4135 Sentence denotes Some respondents suspected viral invasion of the central nervous system (CNS) and injury from SARS-CoV-2.
T51 4136-4230 Sentence denotes Rarely, seizures were attributed to cardiac arrest or stroke that occurred during the illness.
T52 4231-4384 Sentence denotes Most survey respondents (63%) indicated that the new-onset seizures were mostly focal-onset with or without evolution to bilateral tonic–clonic seizures.
T53 4385-4492 Sentence denotes Other respondents identified seizures as generalized, electrographic only or unclassifiable almost equally.
T54 4493-4601 Sentence denotes One-third of respondents reported that they had PWE in their practice that had been diagnosed with COVID-19.
T55 4602-4661 Sentence denotes A majority of these PWE had no change in seizure frequency.
T56 4662-4773 Sentence denotes About 17% of the respondents noted worsening, while none noted an improvement in seizures in PWE with COVID-19.
T57 4774-4901 Sentence denotes In PWE who had not been infected with SARS-CoV-2, most respondents did not see a change in seizure frequency in their patients.
T58 4902-5011 Sentence denotes However, 10% of respondents noted a worsening in seizure frequency, while 5% noted an improvement (Figure 2).
T59 5012-5147 Sentence denotes Worsening of seizure frequency was attributed to increased stress, sleep deprivation, and reduced access to pharmacies and medications.
T60 5148-5352 Sentence denotes However, when survey participants were specifically asked if PWE were reporting increased seizures as a result of emotional stress, more than 80% of respondents either disagreed or were neutral or unsure.
T61 5353-5446 Sentence denotes Conversely, improved seizure control was attributed to better sleep and medication adherence.
T62 5447-5456 Sentence denotes Figure 2.
T63 5458-5498 Sentence denotes Effects of the COVID-19 pandemic on PWE.
T64 5500-5522 Sentence denotes Epilepsy Clinical Care
T65 5523-5620 Sentence denotes Concerns have been raised about the quality of care provided to PWE during the COVID-19 pandemic.
T66 5621-5788 Sentence denotes Forty-three percent of the survey respondents thought that PWE received the expected standard of care during the pandemic, while 34% thought that care was compromised.
T67 5789-5837 Sentence denotes The remaining 17% were either neutral or unsure.
T68 5838-6026 Sentence denotes The majority of respondents felt that there were at least some barriers for PWE in getting appropriate clinical care, testing (including EEG and video EEG monitoring) and elective surgery.
T69 6027-6314 Sentence denotes The reasons for these barriers were thought to include loss of employment and financial stress, lack of access to health care service due to closure, transportation issues, lack of access to technology for telehealth, and reluctance to seek care due to fear of viral outbreak (Figure 3).
T70 6315-6611 Sentence denotes Other barriers identified by some respondents were reduced access to specialty pharmacy services for patients with severe epilepsies, loss of insurance leading to lack of medication coverage, loss of behavioral health services, and increase in stress, anxiety, and depression due to the pandemic.
T71 6612-6824 Sentence denotes Respondents noted that overall, the COVID-19 pandemic has not resulted in a significant change in phone calls from patients to clinics, although both increased and decreased calls were reported in some instances.
T72 6825-6834 Sentence denotes Figure 3.
T73 6836-6885 Sentence denotes Barriers to care of PWE during COVID-19 pandemic.
T74 6887-6914 Sentence denotes Impact on Clinical Practice
T75 6916-6942 Sentence denotes Barriers to Providing Care
T76 6943-7015 Sentence denotes A range of barriers were reported in providing care during the pandemic.
T77 7016-7156 Sentence denotes Most frequently noted were limited access to in-person visits and nonemergency testing reported by 74% and 66% of respondents, respectively.
T78 7157-7375 Sentence denotes Provider fear related to the outbreak and concern for their own well-being was reported by nearly 30%, while lack of personal protective equipment (PPE) and financial considerations were reported by 25% of respondents.
T79 7376-7459 Sentence denotes Technological problems for telehealth visits were noted in only 15% of respondents.
T80 7460-7553 Sentence denotes Only 7% of respondents experienced no barriers in providing patient care during the pandemic.
T81 7554-7724 Sentence denotes One respondent noted that between the pandemic and Centers for Medicare and Medicaid Services (CMS) cutbacks on EEG reimbursement, continuing practice appeared difficult.
T82 7725-8100 Sentence denotes Respondents also cited the following additional practice-related barriers to providing care: prioritization of COVID over nonurgent care; suspensions of epilepsy monitoring units (EMUs), vagus nerve stimulator implantations, and presurgical evaluation and surgery; reopening logistics; staff cuts; and clinic staffing (eg, childcare challenges and fear of exposure to COVID).
T83 8101-8298 Sentence denotes Regarding when respondents expected to return services to pre-COVID-19 levels, the answers formed a normally distributed Bell-shaped curve between now and never, centered at approximately 6 months.
T84 8299-8336 Sentence denotes Only 9% of respondents were not sure.
T85 8337-8410 Sentence denotes Approximately 5% did not feel their practice would ever return to normal.
T86 8412-8440 Sentence denotes Neurophysiologic Evaluations
T87 8441-8604 Sentence denotes About half of respondents (47%) reported that EEGs were discouraged for patients admitted to the hospital with COVID-19 or those suspected of having the infection.
T88 8605-8716 Sentence denotes Even without restrictions, nearly a quarter (22%) reported they were doing fewer studies than usual (Figure 4).
T89 8717-8794 Sentence denotes About 9% responded they were no longer doing continuous video-EEG monitoring.
T90 8795-8871 Sentence denotes In the write in comments, many respondents noted that their EMUs had closed.
T91 8872-9072 Sentence denotes Very few respondents (2%) reported that they were doing more EEGs than usual; of this group, 5 were from institutions where there were no restrictions for performing EEGs during the COVID-19 pandemic.
T92 9073-9082 Sentence denotes Figure 4.
T93 9084-9135 Sentence denotes Inpatient EEG utilization during COVID-19 pandemic.
T94 9137-9173 Sentence denotes Medication Interactions or Shortages
T95 9174-9304 Sentence denotes Almost no respondents had seen unusual interactions between anti-seizure medications (ASM) and medications used to treat COVID-19.
T96 9305-9385 Sentence denotes Medications shortages were noted by approximately 44% of respondents (Figure 5).
T97 9386-9579 Sentence denotes In write-in comments, the most frequently noted shortages were of extended release levetiracetam and midazolam, and other shortages of several IV benzodiazepines were noted by some respondents.
T98 9580-9659 Sentence denotes However, it appears some of these shortages existed from prior to the pandemic.
T99 9660-9789 Sentence denotes By and large, there appeared to be no consistent pattern of shortages of conventional ASMs directly attributable to the pandemic.
T100 9790-9911 Sentence denotes The majority of shortage reports originated from patients; IV anesthetic shortages were reported by inpatient pharmacies.
T101 9912-9921 Sentence denotes Figure 5.
T102 9923-9969 Sentence denotes Medication shortages during COVID-19 pandemic.
T103 9971-9989 Sentence denotes Impact on Trainees
T104 9990-10116 Sentence denotes Trainees (residents and fellows) responded in low numbers and noted that the pandemic has harmed their educational experience.
T105 10117-10196 Sentence denotes They cited reduced patient volumes and canceled clinics as responsible factors.
T106 10197-10410 Sentence denotes Furthermore, the cancelling of interprofessional conferences and educational meetings limited learning and networking opportunities outside the home institution as well as the opportunity to present academic work.
T107 10412-10422 Sentence denotes Telehealth
T108 10423-10597 Sentence denotes Nearly all respondents (90%) indicated a willingness to use telehealth in some capacity; only 2% said that they had not used telehealth and did not plan to use it (Figure 6).
T109 10598-10687 Sentence denotes Many respondents had experienced benefits of telehealth over in-person clinic encounters.
T110 10688-11005 Sentence denotes The benefits included improved access, decreased no-show rates, observations of the home environment, participation of families/caregivers, general efficiency of the visits, flexibility for patients and providers, enhanced integration with multidisciplinary teams, and increased access to psychosocial care providers.
T111 11006-11293 Sentence denotes Respondents also reported that their recent telemedicine experience demonstrates that much of pertinent examinations for epilepsy care, especially for follow-up visits, can be done with telehealth (eg, mental status, gait, coordination, cranial nerves, nystagmus, and ataxia evaluation).
T112 11294-11456 Sentence denotes Problems identified by respondents included technical difficulties, lack of physical contact, and inability to perform diagnostic monitoring and laboratory tests.
T113 11457-11466 Sentence denotes Figure 6.
T114 11468-11504 Sentence denotes Telehealth during COVID-19 pandemic.
T115 11505-11591 Sentence denotes Certain patient populations emerged as likely to particularly benefit from telehealth.
T116 11592-11800 Sentence denotes This included patients living far away from clinics, needing to take extended time off from work to attend clinic visits, with disabilities and requiring transportation, or living in extended care facilities.
T117 11801-12074 Sentence denotes This survey also suggested that the most vulnerable patients are negatively affected by the use of telehealth services, in that the lack of internet access and/or video-capable device has resulted in suboptimal interaction or necessitated an in-person visits to the clinic.
T118 12075-12402 Sentence denotes The Veterans Administration’s Epilepsy Centers of Excellence longstanding experience with telehealth was cited as a model for utilization of telemedicine for providing direct patient care, reading EEG studies remotely or reviewing them for quality assurance, and provider-to-provider consultation in treating epilepsy patients.
T119 12403-12502 Sentence denotes The survey respondents emphasized concerns regarding continued reimbursement for telehealth visits.
T120 12503-12624 Sentence denotes Many respondents wanted advocacy for continued reimbursement parity for telemedicine visits compared to in-person visits.
T121 12626-12636 Sentence denotes Discussion
T122 12637-13173 Sentence denotes On March 11, 2020, concerned by the severity of the infection and the significant level of spread, the World Health Organization classified COVID-19 as a pandemic.1 One week later, the US CMS released guidance recommending that elective surgeries and nonessential medical procedures be postponed to preserve PPE, reduce exposure among health care workers, and allow for the redeployment of medical personnel to provide care where gaps existed.2 This guidance resulted in an unprecedented change in health care delivery for all patients.
T123 13174-13382 Sentence denotes People with epilepsy have a chronic disease, often associated with other comorbidities and daily medication use, making them particularly vulnerable to changes in health care delivery induced by the pandemic.
T124 13383-13555 Sentence denotes Moreover, medical practitioners suddenly found themselves confronted with finding innovative methods of delivering medical care, while worrying about their personal health.
T125 13556-13641 Sentence denotes It was against this backdrop that the AES commissioned this survey of its membership.
T126 13642-13754 Sentence denotes Importantly, this survey was not sent to PWE, rather it focused on AES members perspectives during the pandemic.
T127 13756-13777 Sentence denotes Seizures and COVID-19
T128 13778-14004 Sentence denotes Initially thought to be mainly a respiratory infection, it is now clear that COVID-19 is associated with neurological involvement in more than 30% of patients, with approximately 25% having symptoms indicating CNS dysfunction.
T129 14005-14221 Sentence denotes Fortunately, the incidence of seizures appears to be low (0.5%).3 Although there are case reports of seizures at onset in both adults and children, new-onset seizures and status epilepticus (SE) are rarely described.
T130 14222-14516 Sentence denotes In a recent multicenter, retrospective study of 304 people with no known history of epilepsy in China, neither acute symptomatic seizures nor SE was observed.4 Two people had seizure-like symptoms during hospitalization that were thought to be related to acute stress reaction and hypocalcemia.
T131 14517-14623 Sentence denotes There was no evidence suggesting an additional risk of acute symptomatic seizures in people with COVID-19.
T132 14624-14739 Sentence denotes About a third (30%) of respondents in the current survey reported seeing COVID-19 patients with new-onset seizures.
T133 14740-14948 Sentence denotes This high rate, which is much higher than we might expect given the reported rate of new-onset seizures in the literature (0.5%), is likely reflective of the population surveyed, namely epilepsy specialists.3
T134 14949-15405 Sentence denotes A number of mechanisms of neuropathogenesis related to COVID-19 have been described, including manifestations of systemic disease including hypoxia, metabolic derangements, and multi-organ failure; direct invasion of the nervous system (meningitis/encephalitis); and a postinfection immune-mediated process.5,6 All of these may lead to seizures, but the specific contribution of each mechanism is unclear, and in some cases the cause may be multifactorial.
T135 15406-15613 Sentence denotes Meningoencephalitis associated with COVID 19 with transient seizures has been described in one patient.7 The responses in the AES survey reflected similar uncertainty of possible mechanisms causing seizures.
T136 15614-15728 Sentence denotes There are very few data regarding the type of new-onset seizures seen in patients with COVID-19 in the literature.
T137 15729-16459 Sentence denotes There is a single case report of focal SE as a presenting manifestation in a patient with underlying postencephalitic epilepsy.8 A small case series of 7 patients with COVID-19 presenting with seizures, of which 4 had new-onset seizures, has been reported.9 A patient with COVID-19 related meningoencephalitis was reported to have generalized seizures lasting about a minute.7 One EEG-based case series demonstrates abnormalities seen in encephalopathic patients with COVID-19, including generalized slowing, generalized epileptiform discharges and focal seizures, although many of the patients in the series had preexisting epilepsy.10 In this study, there were 2 patients with focal seizures, 1 was new onset and 1 was in a PWE.
T138 16460-16565 Sentence denotes Additionally, in this study several patients had generalized periodic discharges of triphasic morphology.
T139 16566-16659 Sentence denotes Other patients with COVID-19 related new onset seizures and SE have also been described.11,12
T140 16660-16758 Sentence denotes Respondents in the current survey did not notice an increase in susceptibility of PWE to COVID-19.
T141 16759-16990 Sentence denotes This is supported by a consensus statement which finds no increased risk of acquiring COVID-19 in most PWE.13 Exceptions include PWE who are being treated with immunosuppressant medications or those particularly sensitive to fever.
T142 16991-17273 Sentence denotes However, a recent study that reported on EEG findings in 8 patients with COVID-19 related neurologic problems found 5 (63%) had a history of epilepsy.10 These authors raised the concern that PWE may be at increased risk developing neurologic manifestations if they acquire COVID-19.
T143 17275-17313 Sentence denotes Obtaining and Delivering Epilepsy Care
T144 17314-17433 Sentence denotes Concerns were raised in this survey that PWE could not get the usual care for their medical issues during the pandemic.
T145 17434-17541 Sentence denotes Many of these issues were due to new financial and logistical constraints for patients during the pandemic.
T146 17542-17626 Sentence denotes No comparable data regarding these issues are currently available in the literature.
T147 17627-17722 Sentence denotes Care was also affected due to limitations imposed by hospitals, clinics, and medical practices.
T148 17723-17870 Sentence denotes Institutions across the United States began to restrict or cancel admissions to epilepsy monitoring units (which are typically elective in nature).
T149 17871-18254 Sentence denotes In addition, performing both inpatient and outpatient EEGs was significantly reduced due to the close contact of the EEG technologist with patients and to reduce depletion of PPE.14 Telemedicine visits were encouraged for the care of PWE during the pandemic wherever possible to reduce the risk for PWE and their family for being exposed to the infection in health care facilities.13
T150 18255-18371 Sentence denotes The effect of reduced access to in-person epilepsy care and neurodiagnostic procedures has not been clearly studied.
T151 18372-18581 Sentence denotes An Italian study that surveyed people with and without epilepsy found that those with epilepsy reported a significantly increased risk of seizures and difficulties in obtaining follow-up clinic appointments.15
T152 18582-18655 Sentence denotes Shortage of ASM has not been a major concern during the current pandemic.
T153 18656-18765 Sentence denotes Most respondents did not notice lack of availability of ASM, with the exception of long acting levetiracetam.
T154 18766-19054 Sentence denotes However, the Food and Drug Administration has reported intermittent shortages of medications used to treat acute seizure, such as midazolam and propofol, during the pandemic.16 This is likely due to use of these medications in critically ill patients, not necessarily those with seizures.
T155 19055-19166 Sentence denotes There is also little evidence of the effects of various medications used to treat COVID-19 on seizures and ASM.
T156 19167-19281 Sentence denotes In response, the AES Treatments Committee has created a resource, Managing Patients with Epilepsy during COVID-19:
T157 19282-19640 Sentence denotes Pharmacotherapy-related Recommendations.17 American Epilepsy Society has created a COVID-19 and Epilepsy web portal with information relating to various aspect to care delivery.18 Interestingly, despite almost all participants being impacted in some way by COVID-19, only 41% of respondents to the survey were aware of these resources, and 38% had used them.
T158 19641-19708 Sentence denotes A campaign to increase awareness of this resource may help members.
T159 19710-19720 Sentence denotes Telehealth
T160 19721-20190 Sentence denotes The value of telehealth in neurology has been recognized well before the COVID-19 pandemic, with particularly successful implementation in stroke care.19,20 The feasibility of telehealth in epilepsy care, including delivery of complex care to patients with refractory epilepsy, has similarly been demonstrated, with comparable outcome and high patient satisfaction.13,21-23 The lack of commensurate reimbursement has historically been the barrier to greater adoption.24
T161 20191-20295 Sentence denotes Several early studies have examined the effect of transition to telehealth during the COVID-19 pandemic.
T162 20296-20497 Sentence denotes A recent survey of child neurologists conducting telehealth encounters, in which epilepsy was somewhat overrepresented, revealed >90% satisfactory encounters despite 40% reporting technical challenges.
T163 20498-21003 Sentence denotes Most (86%) reported intending to pursue telehealth in future encounters.25 An international survey of pediatric neurologists treating children with epilepsy revealed that about 25% of practitioners were seeing outpatients exclusively with telehealth and 95% were seeing at least some patients by telehealth.26 A US-based single hospital system evaluation revealed that 67% of outpatient visits were completed via telehealth, 32% with phone visits, and only 1% of visits were in-person clinic encounters.27
T164 21004-21112 Sentence denotes Similar to previous studies, the respondents in the current survey overwhelmingly found value in telehealth.
T165 21113-21181 Sentence denotes Many benefits were noted, including efficiency of the clinic visits.
T166 21182-21345 Sentence denotes Respondents even noted that many of the examination elements that they routinely perform, such as mental status and gait evaluations, could be done via telehealth.
T167 21346-21442 Sentence denotes One shortcoming that was mentioned was the lack of diagnostic monitoring and laboratory testing.
T168 21443-21546 Sentence denotes However, a recent randomized trial revealed little benefit in monitoring serum levels of modern ASMs.28
T169 21547-21779 Sentence denotes Whereas previous efforts in telehealth in epilepsy care have focused on the delivery of care to resource-limited or poorly accessible regions, the current situation has affected health care delivery across all socioeconomic spectra.
T170 21780-21933 Sentence denotes Unfortunately, the most socioeconomically vulnerable patients have difficulty in getting telehealth services as well due to lack of access to technology.
T171 21934-22085 Sentence denotes This is an area that should be promptly and actively addressed, particularly since the near-term outlook for the pandemic remains extremely concerning.
T172 22086-22193 Sentence denotes An important consideration about telehealth raised by respondents to the survey is continued reimbursement.
T173 22194-22438 Sentence denotes While there was overwhelming recognition of the value of telehealth and many respondents saw the value in continuing it long term, they expressed concern that reimbursement models changed after the pandemic, they would be unable to continue it.
T174 22439-22616 Sentence denotes Encouragingly, professional societies are collaborating in a variety of way to advocate for telehealth for PWE as well as others that greatly benefit from this method of care.29
T175 22618-22629 Sentence denotes Limitations
T176 22630-22756 Sentence denotes There are several limitations inherent in this type of study including the potential for recall, sample, and responder biases.
T177 22757-22891 Sentence denotes Furthermore, the survey asks clinicians their impressions of the impact of COVID-19 on PWE in their practice, not patients themselves.
T178 22892-23034 Sentence denotes In addition, the COVID-19 pandemic has been a rapidly evolving phenomenon and this survey represents a snapshot in time early in the pandemic.
T179 23035-23126 Sentence denotes Responses might change if members were surveyed later in the pandemic or even postpandemic.
T180 23128-23139 Sentence denotes Conclusions
T181 23140-23290 Sentence denotes This survey of AES membership conducted in May and June 2020 found that almost all respondents had been impacted in some way by the COVID-19 pandemic.
T182 23291-23334 Sentence denotes Key “Takeaways” are summarized in Figure 7.
T183 23335-23495 Sentence denotes Most health care providers did not perceive that PWE have experienced an increase in seizure frequency during the pandemic or as a result of COVID-19 infection.
T184 23496-23669 Sentence denotes There are many barriers to care that have occurred; however, the pandemic has also forced innovations, such as in telehealth, that have led to enhancements in care delivery.
T185 23670-23826 Sentence denotes The survey identified areas in which to continue to provide services to AES members so that they may more effectively deliver the best possible care to PWE.
T186 23827-23836 Sentence denotes Figure 7.
T187 23838-23852 Sentence denotes Key takeaways.
T188 23854-23875 Sentence denotes Supplemental Material
T189 23876-23979 Sentence denotes Supplemental Material, Appendix_1-AES_COVID_Survey_Questions - The Impact of COVID-19 on Epilepsy Care:
T190 23980-24032 Sentence denotes A Survey of the American Epilepsy Society Membership
T191 24033-24069 Sentence denotes Click here for additional data file.
T192 24070-24175 Sentence denotes Supplemental Material, Appendix_1-AES_COVID_Survey_Questions for The Impact of COVID-19 on Epilepsy Care:
T193 24176-24239 Sentence denotes A Survey of the American Epilepsy Society Membership by Dara V.
T194 24240-24242 Sentence denotes F.
T195 24243-24259 Sentence denotes Albert, Rohit R.
T196 24260-24274 Sentence denotes Das, Jayant N.
T197 24275-24305 Sentence denotes Acharya, Jong Woo Lee, John R.
T198 24306-24335 Sentence denotes Pollard, Vineet Punia, Joy A.
T199 24336-24355 Sentence denotes Keller and Aatif M.
T200 24356-24383 Sentence denotes Husain in Epilepsy Currents