tetano
Editor, Senior Moderator
Crit Care
. 2020 Jul 13;24(1):421.
doi: 10.1186/s13054-020-03121-z.
Neurological manifestations of COVID-19: a systematic review
Gaurav Nepal[SUP] 1 [/SUP], Jessica Holly Rehrig[SUP] 2 [/SUP], Gentle Sunder Shrestha[SUP] 3 [/SUP], Yow Ka Shing[SUP] 4 [/SUP], Jayant Kumar Yadav[SUP] 1 [/SUP], Rajeev Ojha[SUP] 5 [/SUP], Gaurab Pokhrel[SUP] 6 [/SUP], Zhi Lan Tu[SUP] 7 [/SUP], Dong Ya Huang[SUP] 8 [/SUP]
Affiliations
Abstract
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the global spread of coronavirus disease (COVID-19). Our understanding of the impact this virus has on the nervous system is limited. Our review aims to inform and improve decision-making among the physicians treating COVID-19 by presenting a systematic analysis of the neurological manifestations experienced within these patients.
Methods: Any study, released prior to May 20, 2020, that reported neurological manifestations in patients infected by SARS-CoV-2 was systematically reviewed using the PRISMA (Preferred Reporting Items for Systemic review and Meta-Analysis) statement.
Results: Our systematic review included data from 37 articles: twelve retrospective studies, two prospective studies, and the rest case reports/series. The most commonly reported neurological manifestations of COVID-19 were myalgia, headache, altered sensorium, hyposmia, and hypogeusia. Uncommonly, COVID-19 can also present with central nervous system manifestations such as ischemic stroke, intracerebral hemorrhage, encephalo-myelitis, and acute myelitis, peripheral nervous manifestations such as Guillain-Barr? syndrome and Bell's palsy, and skeletal muscle manifestations such as rhabdomyolysis.
Conclusion: While COVID-19 typically presents as a self-limiting respiratory disease, it has been reported in up to 20% of patients to progress to severe illness with multi-organ involvement. The neurological manifestations of COVID-19 are not uncommon, but our study found most resolve with treatment of the underlying infection. Although the timeliness of this review engages current challenges posed by the COVID-19 pandemic, readers must not ignore the limitations and biases intrinsic to an early investigation.
Keywords: Brain; COVID-19; Neurological manifestation; SARS-CoV-2.
. 2020 Jul 13;24(1):421.
doi: 10.1186/s13054-020-03121-z.
Neurological manifestations of COVID-19: a systematic review
Gaurav Nepal[SUP] 1 [/SUP], Jessica Holly Rehrig[SUP] 2 [/SUP], Gentle Sunder Shrestha[SUP] 3 [/SUP], Yow Ka Shing[SUP] 4 [/SUP], Jayant Kumar Yadav[SUP] 1 [/SUP], Rajeev Ojha[SUP] 5 [/SUP], Gaurab Pokhrel[SUP] 6 [/SUP], Zhi Lan Tu[SUP] 7 [/SUP], Dong Ya Huang[SUP] 8 [/SUP]
Affiliations
- PMID: 32660520
- DOI: 10.1186/s13054-020-03121-z
Abstract
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the global spread of coronavirus disease (COVID-19). Our understanding of the impact this virus has on the nervous system is limited. Our review aims to inform and improve decision-making among the physicians treating COVID-19 by presenting a systematic analysis of the neurological manifestations experienced within these patients.
Methods: Any study, released prior to May 20, 2020, that reported neurological manifestations in patients infected by SARS-CoV-2 was systematically reviewed using the PRISMA (Preferred Reporting Items for Systemic review and Meta-Analysis) statement.
Results: Our systematic review included data from 37 articles: twelve retrospective studies, two prospective studies, and the rest case reports/series. The most commonly reported neurological manifestations of COVID-19 were myalgia, headache, altered sensorium, hyposmia, and hypogeusia. Uncommonly, COVID-19 can also present with central nervous system manifestations such as ischemic stroke, intracerebral hemorrhage, encephalo-myelitis, and acute myelitis, peripheral nervous manifestations such as Guillain-Barr? syndrome and Bell's palsy, and skeletal muscle manifestations such as rhabdomyolysis.
Conclusion: While COVID-19 typically presents as a self-limiting respiratory disease, it has been reported in up to 20% of patients to progress to severe illness with multi-organ involvement. The neurological manifestations of COVID-19 are not uncommon, but our study found most resolve with treatment of the underlying infection. Although the timeliness of this review engages current challenges posed by the COVID-19 pandemic, readers must not ignore the limitations and biases intrinsic to an early investigation.
Keywords: Brain; COVID-19; Neurological manifestation; SARS-CoV-2.