Neurological manifestations in COVID-19: a systematic review and meta-analysis. (14th October 2020)

• Record Type: Journal Article
• Authors: Chua, Tzy Harn; Xu, Zheyu; King, Nicolas Kon Kam
• Is Part Of: Brain injury. Volume 34:Number 12(2020)
• Page Start: 1549
• Page End: 1568
• Publication Date: 2020-10-14
• Subjects: COVID-19 -- neurological -- Guillain-Barré syndrome -- encephalitis -- cerebrovascular; Brain damage -- Periodicals; Brain -- Wounds and injuries -- Periodicals; Brain Injuries -- Periodicals; 617.481
• DOI: 10.1080/02699052.2020.1831606
• Languages: English
• ISSNs: 0269-9052

Abstract

ABSTRACT: Objective: Following the outbreak of coronavirus 2019 (COVID-19), there is strong evidence of neurological involvement in these patients. We aimed to determine the clinical characteristics of neurological manifestations in COVID-19. Method: A systematic review of studies reporting neurological manifestations published between 1 December, 2019 and 11 May, 2020 was performed. Studies were grouped based on neurological manifestation. Pooled analyses of individual patient's clinical characteristics and olfactory and gustatory dysfunction prevalence were performed. Results: Of 486 studies identified, 48 were included. 70 patients with 73 neurological manifestations were reported. 39 (53.4%) patients had stroke, 18 (24.7%) had Guillain-Barré syndrome and variants, 11 (15.1%) had meningitis, encephalitis, encephalopathy, or myelitis, and five (6.8%) had seizures. They had a mean age of 61.9 ± 17.7 years (60.6% male). Neurological disease occurred 8.1 ± 6.8 days from initial symptoms. Average mortality rate was 17.8%. Stroke has a mortality rate of 25.6%. Olfactory and gustatory dysfunction occurred in 59.9% and 57.5%, respectively. Conclusions: Stroke is the most frequently reported neurological manifestation in COVID-19 and has the highest mortality rate. Neurological manifestations tend to develop one to two weeks after the onset of respiratory disease. There is significant morbidity and mortality associated with COVID-19 neurological manifestations.