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Objective: The aim was to determine the prevalence and risk factors for electrographic seizures and other electroencephalographic (EEG) patterns in patients with Coronavirus disease 2019 (COVID-19) undergoing clinically indicated continuous electroencephalogram (cEEG) monitoring and to assess whether EEG findings are associated with outcomes.Methods: We identified 197 patients with COVID-19 referred for cEEG at 9 participating centers. Medical records and EEG reports were reviewed retrospectively to determine the incidence of and clinical risk factors for seizures and other epileptiform patterns. Multivariate Cox proportional hazards analysis assessed the relationship between EEG patterns and clinical outcomes.Results: Electrographic seizures were detected in 19 (9.6%) patients, including nonconvulsive status epilepticus (NCSE) in 11 (5.6%). Epileptiform abnormalities (either ictal or interictal) were present in 96 (48.7%). Preceding clinical seizures during hospitalization were associated with both electrographic seizures (36.4% in those with vs 8.1% in those without prior clinical seizures, odds ratio [OR] 6.51, p = 0.01) and NCSE (27.3% vs 4.3%, OR 8.34, p = 0.01). A pre-existing intracranial lesion on neuroimaging was associated with NCSE (14.3% vs 3.7%; OR 4.33, p = 0.02). In multivariate analysis of outcomes, electrographic seizures were an independent predictor of in-hospital mortality (hazard ratio [HR] 4.07 [1.44-11.51], p < 0.01). In competing risks analysis, hospital length of stay increased in the presence of NCSE (30 day proportion discharged with vs without NCSE: HR 0.21 [0.03-0.33] vs 0.43 [0.36-0.49]).Interpretation: This multicenter retrospective cohort study demonstrates that seizures and other epileptiform abnormalities are common in patients with COVID-19 undergoing clinically indicated cEEG and are associated with adverse clinical outcomes. ANN NEUROL 2021;89:872-883. [ABSTRACT FROM AUTHOR]

Background and Aim Early diagnosis of solid pancreatic lesions ( SPLs) enables prompt treatment. The study aims to identify factors differentiating metastatic lesion to the pancreas ( PMET) from pancreatic ductal adenocarcinoma ( PDAC) and pancreatic neuroendocrine tumors ( PNETs). Methods This is a retrospective study at a tertiary cancer center. Consecutive patients referred for endoscopic ultrasound ( EUS) of SPLs from 2004 to 2011 were reviewed. The main outcomes were pre- EUS-FNA (endoscopic ultrasound-guided fine needle aspiration) predictors and diagnostic accuracy of EUS-FNA for PMETs. Results Among a total of 1108 EUS- FNAs for pancreatic lesions, 672 patients had neoplastic SPLs ( PMETs = 53; PDACs = 528, PNETs = 91). The sensitivity, specificity, positive predictive value, and accuracy of EUS-FNA for diagnosis of PMETs were 84.9%, 100%, 100%, and 98.8%, respectively. The mean number of EUS-FNA passes for diagnosis of PMET was 3.1 per patient. For each endosonographer, preceding 3-year EUS volume (mean/year) significantly correlated with fewer needle passes (rs[−0.30], P = 0.03). The most common PMET was renal cell carcinoma. Stratified multivariate analyses were performed. Compared with patients with PDACs, PMETs were more common in men (odds ratio [ OR] = 2.0; 95% confidence interval [ CI] = 1.0-4.0); located in the pancreatic tail ( OR = 2.4; 95% CI = 1.1-5.2); and were less likely with increasing age ( OR = 0.95; 95% CI = 0.92-0.99), presence of major symptoms (abdomen pain/diarrhea/weight loss; OR = 0.2; 95% CI = 0.1-0.4), elevated bilirubin ( OR = 0.3; 95% CI = 0.13-0.69), and imaging evidence of arterial invasion ( OR = 0.15; 95% CI = 0.03-0.67). Compared with PNETs, PMETs were more common with increase age ( OR = 1.05; 95% CI = 1.02-1.08) and increasing lesion size ( OR = 1.03; 95% CI = 1.0-1.1), and were less likely in patients with diabetes ( OR = 0.34; 95% CI = 0.11-0.99). Conclusion Among the largest numbers of neoplastic SPLs evaluated at a single center, pre-test features reliably characterize, and EUS-FNA provides a highly specific diagnosis of PMETs. [ABSTRACT FROM AUTHOR]