Neurological manifestations and complications of coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis

BMC Neurology

Ola Soudah¹  Mohammad Abu-Rub²  Khalid Alsherbini³  Ahmed Yassin⁴  Khalid El-Salem⁴  Mohammed Nawaiseh⁵  Ala Shaban⁶ 

[1] Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan;Department of Neurology, The George Washington University, Washington, DC, USA;Department of Neurology, University of Tennessee Health Science Center, Methodist University Hospital, Memphis, TN, USA;Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, P.O.Box 630001, 22110, Irbid, Jordan;Graduate of The University of Jordan, Amman, Jordan;Intern at Jordanian Royal Medical Services, Amman, Jordan;Graduate of The University of Jordan, Amman, Jordan;Researcher, King Hussein Cancer Center, Amman, Jordan;

关键词: COVID-19;    Coronavirus;    Neurology;    CNS;    Clinical features;    Meta-analysis;    Systematic review;   

DOI  :  10.1186/s12883-021-02161-4

来源: Springer

【 摘 要 】

BackgroundThe spectrum of neurological involvement in COVID-19 is not thoroughly understood. To the best of our knowledge, no systematic review with meta-analysis and a sub-group comparison between severe and non-severe cases has been published. The aim of this study is to assess the frequency of neurological manifestations and complications, identify the neurodiagnostic findings, and compare these aspects between severe and non-severe COVID-19 cases.MethodsA systematic search of PubMed, Scopus, EBSCO, Web of Science, and Google Scholar databases was conducted for studies published between the 1st of January 2020 and 22nd of April 2020. In addition, we scanned the bibliography of included studies to identify other potentially eligible studies. The criteria for eligibility included studies published in English language (or translated to English), those involving patients with COVID-19 of all age groups, and reporting neurological findings. Data were extracted from eligible studies. Meta-analyses were conducted using comprehensive meta-analysis software. Random-effects model was used to calculate the pooled percentages and means with their 95% confidence intervals (CIs). Sensitivity analysis was performed to assess the effect of individual studies on the summary estimate. A subgroup analysis was conducted according to severity. The main outcomes of the study were to identify the frequency and nature of neurological manifestations and complications, and the neuro-diagnostic findings in COVID-19 patients.Results44 articles were included with a pooled sample size of 13,480 patients. The mean age was 50.3 years and 53% were males. The most common neurological manifestations were: Myalgia (22.2, 95% CI, 17.2 to 28.1%), taste impairment (19.6, 95% CI, 3.8 to 60.1%), smell impairment (18.3, 95% CI, 15.4 to 76.2%), headache (12.1, 95% CI, 9.1 to 15.8%), dizziness (11.3, 95% CI, 8.5 to 15.0%), and encephalopathy (9.4, 95% CI, 2.8 to 26.6%). Nearly 2.5% (95% CI, 1 to 6.1%) of patients had acute cerebrovascular diseases (CVD). Myalgia, elevated CK and LDH, and acute CVD were significantly more common in severe cases. Moreover, 20 case reports were assessed qualitatively, and their data presented separately.ConclusionsNeurological involvement is common in COVID-19 patients. Early recognition and vigilance of such involvement might impact their overall outcomes.

【 授权许可】

CC BY