Neurological Manifestations in COVID-19 Infection: A Systematic Review and Meta-Analysis

Canadian Journal of Neurological Sciences - Tập 48 Số 1 - Trang 66-76 - 2021
Maria Epifania Collantes1, Adrian I. Espiritu2,1, Marie Charmaine C. Sy1, Veeda Michelle M. Anlacan1, Roland Dominic G. Jamora1
1Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
2Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines

Tóm tắt

ABSTRACT:Background:

Growing evidence showed that coronavirus disease 2019 (COVID-19) infection may present with neurological manifestations. This review aimed to determine the neurological manifestations and complications in COVID-19.

Methods:

We conducted a systematic review and meta-analysis that included cohort and case series/reports involving a population of patients confirmed with COVID-19 infection and their neurologic manifestations. We searched the following electronic databases until April 18, 2020: PubMed, Embase, Scopus, and World Health Organization database (PROSPERO registration number: CRD42020180658).

Results:

From 403 articles identified, 49 studies involving a total of 6,335 confirmed COVID-19 cases were included. The random-effects modeling analysis for each neurological symptom showed the following proportional point estimates with 95% confidence intervals: “headache” (0.12; 0.10–0.14; I2 = 77%), “dizziness” (0.08; 0.05–0.12; I2 = 82%), “headache and dizziness” (0.09; 0.06–0.13; I2 = 0%), “nausea” (0.07; 0.04–0.11; I2 = 79%), “vomiting” (0.05; 0.03–0.08; I2 = 74%), “nausea and vomiting” (0.06; 0.03–0.11; I2 = 83%), “confusion” (0.05; 0.02–0.14; I2 = 86%), and “myalgia” (0.21; 0.18–0.25; I2 = 85%). The most common neurological complication associated with COVID-19 infection was vascular disorders (n = 23); other associated conditions were encephalopathy (n = 3), encephalitis (n = 1), oculomotor nerve palsy (n = 1), isolated sudden-onset anosmia (n = 1), Guillain–Barré syndrome (n = 1), and Miller–Fisher syndrome (n = 2). Most patients with neurological complications survived (n = 14); a considerable number of patients died (n = 7); and the rest had unclear outcomes (n = 12).

Conclusion:

This review revealed that neurologic involvement may manifest in COVID-19 infection. What has initially been thought of as a primarily respiratory illness has evolved into a wide-ranging multi-organ disease.

Từ khóa


Tài liệu tham khảo

Gane, 2020, Isolated sudden onset anosmia in COVID-19 infection. A novel syndrome?, Rhinology, 58, 194

10.1016/S0140-6736(20)30566-3

10.1016/j.nmni.2020.100669

10.3390/v12010014

10.2139/ssrn.3550025

10.1136/svn-2020-000382

10.1016/j.bbi.2020.04.017

10.1093/cid/ciaa199

10.1148/radiol.2020200274

10.1128/JVI.78.7.3398-3406.2004

10.1056/NEJMc2007575

10.1007/s00415-020-09773-9

Gupta, 2020, Clinical and epidemiologic profile of the initial COVID-19 patients at a tertiary care centre in India, Monaldi Arch Chest Dis, 90, 193

10.1016/j.jinf.2020.03.038

10.1212/WNL.0000000000009619

13. Li, X , Xu, S , Yu, M , et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020;S0091-6749(20)30495-4.

10.1371/journal.pmed.1000100

10.1183/13993003.00524-2020

10.1016/j.bbi.2020.03.031

10.1016/j.coviro.2014.12.009

10.1016/S0140-6736(20)30673-5

10.1016/j.chom.2013.03.010

Chahrour, 2020, A bibliometric analysis of COVID-19 research activity: a call for increased output, Cureus, 12, e7357

10.1111/all.14238

10.1128/JVI.03368-12

8. Centers for Disease Control and Prevention. Evaluating and testing persons for coronavirus disease 2019 (COVID-19) [Internet]. 2020 [cited 2020 Apr 7]; Available at: https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html

10.1016/j.tmaid.2020.101664

10.1021/acschemneuro.0c00122

10.1016/S1473-3099(20)30086-4

10.1136/bmj.m606

10.3201/eid2607.200598

10.1016/S2213-2600(20)30079-5

10.1016/S0140-6736(20)30183-5

10.1001/jamaneurol.2020.1127

10.1038/ni.3656

10.1056/NEJMoa2002032

Filatov, 2020, Neurological complications of coronavirus disease (COVID-19): encephalopathy, Cureus, 12, 1

10.1016/j.ijid.2020.03.070

10.1001/jama.2020.1585

10.5812/ircmj.102828

10.1016/j.jns.2020.116832

10.1148/radiol.2020200230

10.1097/RLI.0000000000000670

10.1016/S0140-6736(20)30211-7

10.1016/j.ijid.2020.03.062

10.1136/bmj.m1091

10.1007/s11427-020-1643-8

10.1016/S1474-4422(20)30109-5

10.1002/jmv.25888

10.1007/s10140-020-01775-4

10.1016/S0140-6736(20)30251-8

10.1007/s00259-020-04735-9

10.1007/s11606-020-05762-w

38. Chen, T , Dai, Z , Mo, P , et al. Clinical characteristics and outcomes of older patients with coronavirus disease 2019 (COVID-19) in Wuhan, China (2019): A single-centered, retrospective study. J Gerontol Ser A [Internet]. 2020;glaa089. Available at: https://academic.oup.com/biomedgerontology/advance-article/doi/10.1093/gerona/glaa089/5819242

10.1136/bmjebm-2017-110853

10.1164/rccm.202002-0445OC

10.1183/09031936.01.00093001

10.1148/radiol.2020200370

10.1001/jama.2020.1623

Zheng, 2020, Clinical characteristics of 161 cases of corona virus disease 2019 (COVID-19) in Changsha, Eur Rev Med Pharmacol Sci, 24, 3404

10.1148/radiol.2020201187

10.1056/NEJMc2008597

10.3346/jkms.2020.35.e142

10.1097/CM9.0000000000000744

10.5582/bst.2020.01030

10.1016/j.jinf.2020.02.018

Song, 2010, Dissemination and publication of research findings: an updated review of related biases, Health Technol Assess (Rockv), 14, iii

26. Wang, X , Fang, J , Zhu, Y , et al. Clinical characteristics of non-critically ill patients with novel coronavirus infection (COVID-19) in a Fangcang Hospital. Clin Microbiol Infect. 2020;S1198-743X(20)30177-4.

Thông tin
Thông tin xuất bản

Canadian Journal of Neurological Sciences

Tập 48 Số 1

66-76

Thông tin tác giả