1. A systematic review of neurological symptoms and complications of COVID-19
- Author
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Gereon R. Fink, Clemens Warnke, Oezguer A. Onur, Sarah Laurent, Xiangliang Chen, Nina N. Kleineberg, and Finja Schweitzer
- Subjects
0301 basic medicine ,Nervous system ,medicine.medical_specialty ,Pediatrics ,Neurology ,Clinical Neurology ,Disease ,Review ,03 medical and health sciences ,0302 clinical medicine ,Neuro-COVID ,medicine ,Humans ,Clinical significance ,ddc:610 ,Neuroradiology ,business.industry ,SARS-CoV-2 ,Multiple sclerosis ,Meningoencephalitis ,COVID-19 ,medicine.disease ,030104 developmental biology ,Systematic review ,Neurology (clinical) ,Nervous System Diseases ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
Objective To study the frequency of neurological symptoms and complications in COVID-19 patients in a systematic review of the literature. Methods Relevant studies were identified through electronic explorations of PubMed, medRxiv, and bioRxiv. Besides, three Chinese databases were searched. A snowballing method searching the bibliographies of the retrieved references was applied to identify potentially relevant articles. Articles published within 1 year prior to April 20th, 2020, were screened with no language restriction imposed. Databases were searched for terms related to SARS-CoV-2/COVID-19 and neurological manifestations, using a pre-established protocol registered on the International Prospective Register of Systematic Reviews database (ID: CRD42020187994). Results A total of 2441 articles were screened for relevant content, of which 92 full-text publications were included in the analyses of neurological manifestations of COVID-19. Headache, dizziness, taste and smell dysfunctions, and impaired consciousness were the most frequently described neurological symptoms, the latter more often among patients with a severe or critical disease course. To date, only smaller cohort studies or single cases have reported cerebrovascular events, seizures, meningoencephalitis, and immune-mediated neurological diseases, not suitable for quantitative analysis. Conclusion The most frequent neurological symptoms reported in association with COVID-19 are non-specific for the infection with SARS-CoV-2. Although SARS-CoV-2 may have the potential to gain direct access to the nervous system, so far, SARS-CoV-2 was detected in the cerebrospinal fluid in two cases only. Standardized international registries are needed to clarify the clinical relevance of the neuropathogenicity of SARS-CoV-2 and to elucidate a possible impact of SARS-CoV-2 infection on common neurological disease, such as Alzheimer’s, Parkinson’s disease or multiple sclerosis.
- Published
- 2020