To evaluate whether the COVID-19 era was associated with changing trends in volume, etiologies, and outcomes of adults ≥65 presenting to a tertiary medical center in New York state with status epilepticus (SE).

194 encounters were identified (pre n=82, post n=112). Mean quarterly counts increased from 6.46 (pre) to 8.69 (post) (Welch p=0.061). In the pre-specific count model, the post period was associated with a 35% higher quarterly rate of SE encounters (rate ratio 1.35, 95% CI 1.01-1.78, p=0.04). While we observed no significant differences in the etiology mix pre vs post, infectious etiologies showed a trend toward higher share post (1.2% vs 7.3%, Fisher p=0.081). For secondary outcomes, breakthrough SE had a lower in-hospital mortality than new-onset SE (10.5% vs 31.4%, Fisher p=0.002) and a shorter LOS (median 5.0 vs 9.0 days, Wilcoxon p=0.0036).

Our findings reflect an increased SE case burden with a trend towards infectious etiologies during the COVID-19 era. Secondary outcomes point to lower in-hospital mortality and shorter LOS in breakthrough SE patients.