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Article: Neurological manifestations of COVID-19 and other coronaviruses: A systematic review.

Correia, Alyne Oliveira / Feitosa, Pedro Walisson Gomes / Moreira, Jorge Lucas de Sousa / Nogueira, Samuel Átila Rodrigues / Fonseca, Ricardo Brandão / Nobre, Maria Elizabeth Pereira

Neurology, psychiatry, and brain research

2020 Volume 37, Page(s) 27–32

Abstract: ... neurological manifestations associated with COVID-19 and other coronaviruses. The search was carried out in the electronic ... COVID-19" and "neurologic manifestations" or "neurological symptoms" or "meningitis" or "encephalitis ... Coronaviruses have important neurotropic potential and they cause neurological alterations that range from mild ...

Abstract	Objective: To describe the main neurological manifestations related to coronavirus infection in humans. Methodology: A systematic review was conducted regarding clinical studies on cases that had neurological manifestations associated with COVID-19 and other coronaviruses. The search was carried out in the electronic databases PubMed, Scopus, Embase, and LILACS with the following keywords: "coronavirus" or "Sars-CoV-2" or "COVID-19" and "neurologic manifestations" or "neurological symptoms" or "meningitis" or "encephalitis" or "encephalopathy," following the Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Seven studies were included. Neurological alterations after CoV infection may vary from 17.3% to 36.4% and, in the pediatric age range, encephalitis may be as frequent as respiratory disorders, affecting 11 % and 12 % of patients, respectively. The Investigation included 409 patients diagnosed with CoV infection who presented neurological symptoms, with median age range varying from 3 to 62 years. The main neurological alterations were headache (69; 16.8 %), dizziness (57, 13.9 %), altered consciousness (46; 11.2 %), vomiting (26; 6.3 %), epileptic crises (7; 1.7 %), neuralgia (5; 1.2 %), and ataxia (3; 0.7 %). The main presumed diagnoses were acute viral meningitis/encephalitis in 25 (6.1 %) patients, hypoxic encephalopathy in 23 (5.6 %) patients, acute cerebrovascular disease in 6 (1.4 %) patients, 1 (0.2 %) patient with possible acute disseminated encephalomyelitis, 1 (0.2 %) patient with acute necrotizing hemorrhagic encephalopathy, and 2 (1.4 %) patients with CoV related to Guillain-Barré syndrome. Conclusion: Coronaviruses have important neurotropic potential and they cause neurological alterations that range from mild to severe. The main neurological manifestations found were headache, dizziness and altered consciousness.
Keywords	covid19
Language	English
Publishing date	2020-05-31
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	1128315-4
ISSN	0941-9500
ISSN	0941-9500
DOI	10.1016/j.npbr.2020.05.008
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Article: Neurological manifestations of COVID-19 and other coronaviruses: A systematic review

Correia, Alyne Oliveira / Feitosa, Pedro Walisson Gomes / Moreira, Jorge Lucas de Sousa / Nogueira, Samuel Átila Rodrigues / Fonseca, Ricardo Brandão / Nobre, Maria Elizabeth Pereira

Neurol. Psychiatry Brain Res.

Abstract: ... neurological manifestations associated with COVID-19 and other coronaviruses. The search was carried out in the electronic ... COVID-19” and “neurologic manifestations” or “neurological symptoms” or “meningitis” or “encephalitis ... encephalopathy, and 2 (1.4 %) patients with CoV related to Guillain-Barré syndrome. Conclusion: Coronaviruses ...

Abstract	Objective: To describe the main neurological manifestations related to coronavirus infection in humans. Methodology: A systematic review was conducted regarding clinical studies on cases that had neurological manifestations associated with COVID-19 and other coronaviruses. The search was carried out in the electronic databases PubMed, Scopus, Embase, and LILACS with the following keywords: “coronavirus” or “Sars-CoV-2” or “COVID-19” and “neurologic manifestations” or “neurological symptoms” or “meningitis” or “encephalitis” or “encephalopathy,” following the Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Seven studies were included. Neurological alterations after CoV infection may vary from 17.3% to 36.4% and, in the pediatric age range, encephalitis may be as frequent as respiratory disorders, affecting 11 % and 12 % of patients, respectively. The Investigation included 409 patients diagnosed with CoV infection who presented neurological symptoms, with median age range varying from 3 to 62 years. The main neurological alterations were headache (69; 16.8 %), dizziness (57, 13.9 %), altered consciousness (46; 11.2 %), vomiting (26; 6.3 %), epileptic crises (7; 1.7 %), neuralgia (5; 1.2 %), and ataxia (3; 0.7 %). The main presumed diagnoses were acute viral meningitis/encephalitis in 25 (6.1 %) patients, hypoxic encephalopathy in 23 (5.6 %) patients, acute cerebrovascular disease in 6 (1.4 %) patients, 1 (0.2 %) patient with possible acute disseminated encephalomyelitis, 1 (0.2 %) patient with acute necrotizing hemorrhagic encephalopathy, and 2 (1.4 %) patients with CoV related to Guillain-Barré syndrome. Conclusion: Coronaviruses have important neurotropic potential and they cause neurological alterations that range from mild to severe. The main neurological manifestations found were headache, dizziness and altered consciousness.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #437051
Database	COVID19

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Article ; Online: Neurological manifestations of COVID-19 and other coronavirus infections: A systematic review.

Montalvan, V / Lee, J / Bueso, T / De Toledo, J / Rivas, K

Clinical neurology and neurosurgery

2020 Volume 194, Page(s) 105921

Abstract: ... Objective: To review the neurological aspects of SARS-cov2 and other coronavirus, including transmission ... of cases, cohort studies, and systematic reviews related to neurological manifestations of SARS- CoV-2 and ... demyelination, neuropathy, and stroke have been associated with COVID-19. Infection through the cribriform plate ...

Abstract	Background: Increasing research reports neurological manifestations of COVID-19 patients. SARS-CoV-2 shares homology with other human coronaviruses that have also had nervous system involvement. Objective: To review the neurological aspects of SARS-cov2 and other coronavirus, including transmission pathways, mechanisms of invasion into the nervous system, and mechanisms of neurological disease. Methods: We conducted a systematic review of articles in PubMed, SCOPUS and EMBASE data bases. Reviewed evidence is presented in sections of this manuscript which includes pathogenesis, neuro-invasion, encephalitis, Guillain-Barré, ADEM, multiple sclerosis, polyneuropathy, and cerebrovascular disease. Results: A total 67 studies were included in the final analysis of experimental studies, case reports, series of cases, cohort studies, and systematic reviews related to neurological manifestations of SARS- CoV-2 and other human coronavirus infections. The SARS-CoV-2 receptor is expressed in the nervous system. Common reported symptoms included hyposmia, headaches, weakness, altered consciousness. Encephalitis, demyelination, neuropathy, and stroke have been associated with COVID-19. Infection through the cribriform plate and olfactory bulb and dissemination through trans-synaptic transfer are some of the mechanisms proposed. Invasion of the medullary cardiorespiratory center by SARS-CoV-2 may contribute to the refractory respiratory failure observed in critically-ill COVID-19 patients. Conclusion: An increasing number of reports of COVID-19 patients with neurological disorders add to emergent experimental models with neuro-invasion as a reasonable concern that SARS-CoV-2 is a new neuropathogen. How it may cause acute and chronic neurologic disorders needs to be clarified in future research.
MeSH term(s)	Betacoronavirus ; Brain/diagnostic imaging ; Brain/metabolism ; Brain/virology ; COVID-19 ; Coronavirus Infections/diagnostic imaging ; Coronavirus Infections/epidemiology ; Coronavirus Infections/metabolism ; Humans ; Nervous System Diseases/diagnostic imaging ; Nervous System Diseases/epidemiology ; Nervous System Diseases/metabolism ; Observational Studies as Topic/methods ; Pandemics ; Pneumonia, Viral/diagnostic imaging ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/metabolism ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-05-15
Publishing country	Netherlands
Document type	Case Reports ; Journal Article ; Systematic Review
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2020.105921
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Article ; Online: Neurological manifestations and complications of coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis.

Yassin, Ahmed / Nawaiseh, Mohammed / Shaban, Ala / Alsherbini, Khalid / El-Salem, Khalid / Soudah, Ola / Abu-Rub, Mohammad

BMC neurology

2021 Volume 21, Issue 1, Page(s) 138

Abstract: ... and non-severe COVID-19 cases.: Methods: A systematic search of PubMed, Scopus, EBSCO, Web ... translated to English), those involving patients with COVID-19 of all age groups, and reporting ... To the best of our knowledge, no systematic review with meta-analysis and a sub-group comparison between ...

Abstract	Background: The 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. Methods: A 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. Results: 44 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. Conclusions: Neurological involvement is common in COVID-19 patients. Early recognition and vigilance of such involvement might impact their overall outcomes.
MeSH term(s)	Brain Diseases/complications ; COVID-19 ; Humans ; SARS-CoV-2
Language	English
Publishing date	2021-03-30
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2041347-6
ISSN	1471-2377 ; 1471-2377
ISSN (online)	1471-2377
ISSN	1471-2377
DOI	10.1186/s12883-021-02161-4
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Article: Neurological manifestations of COVID-19 and other coronavirus infections: A systematic review

Montalvan, V / Lee, J / Bueso, T / De Toledo, J / Rivas, K

Clin Neurol Neurosurg

Abstract: ... OBJECTIVE: To review the neurological aspects of SARS-cov2 and other coronavirus, including transmission ... cohort studies, and systematic reviews related to neurological manifestations of SARS- CoV-2 and other human ... have been associated with COVID-19. Infection through the cribriform plate and olfactory bulb and ...

Abstract	BACKGROUND: Increasing research reports neurological manifestations of COVID-19 patients. SARS-CoV-2 shares homology with other human coronaviruses that have also had nervous system involvement. OBJECTIVE: To review the neurological aspects of SARS-cov2 and other coronavirus, including transmission pathways, mechanisms of invasion into the nervous system, and mechanisms of neurological disease. METHODS: We conducted a systematic review of articles in PubMed, SCOPUS and EMBASE data bases. Reviewed evidence is presented in sections of this manuscript which includes pathogenesis, neuro-invasion, encephalitis, Guillain-Barré, ADEM, multiple sclerosis, polyneuropathy, and cerebrovascular disease. RESULTS: A total 67 studies were included in the final analysis of experimental studies, case reports, series of cases, cohort studies, and systematic reviews related to neurological manifestations of SARS- CoV-2 and other human coronavirus infections. The SARS-CoV-2 receptor is expressed in the nervous system. Common reported symptoms included hyposmia, headaches, weakness, altered consciousness. Encephalitis, demyelination, neuropathy, and stroke have been associated with COVID-19. Infection through the cribriform plate and olfactory bulb and dissemination through trans-synaptic transfer are some of the mechanisms proposed. Invasion of the medullary cardiorespiratory center by SARS-CoV-2 may contribute to the refractory respiratory failure observed in critically-ill COVID-19 patients. CONCLUSION: An increasing number of reports of COVID-19 patients with neurological disorders add to emergent experimental models with neuro-invasion as a reasonable concern that SARS-CoV-2 is a new neuropathogen. How it may cause acute and chronic neurologic disorders needs to be clarified in future research.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #308264
Database	COVID19

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Article: Review of Neurological Manifestations of SARS-CoV-2.

Priyal / Sehgal, Vineet / Kapila, Saniya / Taneja, Rishabh / Mehmi, Prachi / Gulati, Nihal

Cureus

2023 Volume 15, Issue 4, Page(s) e38194

Abstract: ... pathogenic cause of the various neurological manifestations of COVID-19. We searched Pubmed/Medline and ... for post-coronavirus disease 2019 (COVID-19)-sequelae. It has not yet been shown that the virus ... can penetrate the central nervous system (CNS) directly. This review aims to describe the disease and root ...

Abstract	Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can affect any part of the neuraxis. Many neurological conditions have been attributed to be caused by SARS-CoV-2, namely encephalopathy (acute necrotizing encephalopathy and encephalopathy with reversible splenial lesions), seizures, stroke, cranial nerve palsies, meningoencephalitis, acute disseminated encephalomyelitis (ADEM), transverse myelitis (long and short segment), Guillain-Barré syndrome (GBS) and its variants, polyneuritis cranialis, optic neuritis (ON), plexopathy, myasthenia gravis (MG), and myositis. The pathophysiology differs depending on the time frame of presentation. In patients with concomitant pulmonary disease, for instance, acute neurological illness appears to be caused by endotheliopathy and cytokine storm. Autoimmunity and molecular mimicry are causative for post-coronavirus disease 2019 (COVID-19)-sequelae. It has not yet been shown that the virus can penetrate the central nervous system (CNS) directly. This review aims to describe the disease and root pathogenic cause of the various neurological manifestations of COVID-19. We searched Pubmed/Medline and Google Scholar using the keywords "SARS-CoV-2" and "neurological illness" for articles published between January 2020 and November 2022. Then, we used the SWIFT-Review (Sciome LLC, North Carolina, United States), a text-mining workbench for systematic review, to classify the 1383 articles into MeSH hierarchical tree codes for articles on various parts of the nervous system, such as the CNS, peripheral nervous system, autonomic nervous system, neuromuscular junction, sensory system, and musculoskeletal system. Finally, we reviewed 152 articles in full text. SARS-CoV-2 RNA has been found in multiple brain areas without any histopathological changes. Despite the absence of in vivo virions or virus-infected cells, CNS inflammation has been reported, especially in the olfactory bulb and brain stem. SARS-CoV-2 genomes and proteins have been found in affected individuals' brain tissues, but corresponding neuropathologic changes are seldom found in these cases. Additionally, viral RNA can rarely be identified in neurological patients' CSF post hoc SARS-CoV-2 infection. Most patients with neurological symptoms do not have active viral replication in the nervous system and infrequently have typical clinical and laboratory characteristics of viral CNS infections. Endotheliopathy and the systemic inflammatory response to SARS-CoV-2 infection play a crucial role in developing neuro-COVID-19, with proinflammatory cytokine release mediating both pathological pathways. The systemic inflammatory mediators likely activate astrocytes and microglia across the blood-brain barrier, indirectly affecting CNS-specific immune activation and tissue injury. The management differs according to co-morbidities and the neurological disorder.
Language	English
Publishing date	2023-04-27
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.38194
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: A Systematic Review of Neurological Manifestations of COVID-19.

Thapa Magar, Sumeru / Lokhandwala, Hatim I / Batool, Saima / Zahoor, Faiqa / Zaidi, Syeda Kisa Fatima / Sahtiya, Saveeta / Khemani, Deepa / Kumar, Sumeet / Voloshyna, Diana / Saleem, Faraz / Ghaffari, Muhammad Abu Zar

Cureus

2022 Volume 14, Issue 8, Page(s) e28309

Abstract: ... and long-term neurological effects of the COVID-19 virus. Some neurological problems include headache ... contracted COVID-19 also exhibit neurological features such as loss of taste and smell, reduced consciousness ... of neurologic aspects of COVID-19, as understanding neurological symptoms may help with the management and ...

Abstract	The coronavirus can infect the upper respiratory tract, sinuses, and nose, and its severity manifests in its respiratory symptoms and neurological and psychological consequences. The majority of people who have COVID-19 present with moderate flu-like illness, and patients who are elderly with comorbid conditions, such as hypertension and diabetes, are more prone to experience severe illness and death. However, in the ongoing COVID-19 pandemic, neurological consequences have become a substantial source of morbidity and mortality. COVID-19 poses a global hazard to the nervous system because of its widespread dispersion and multiple pathogenic pathways. This review offers a critical assessment of the acute and long-term neurological effects of the COVID-19 virus. Some neurological problems include headache, dizziness, myalgia/fatigue, meningitis, ischemic/hemorrhagic stroke, and myelitis. Other people who have contracted COVID-19 also exhibit neurological features such as loss of taste and smell, reduced consciousness, and Guillain-Barré syndrome. This study seeks to help neurologists comprehend the wide range of neurologic aspects of COVID-19, as understanding neurological symptoms may help with the management and enhance the patient's outcomes.
Language	English
Publishing date	2022-08-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.28309
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Article: Cardiovascular and Neurological Complications of COVID-19: A Narrative Review.

Sousa Rêgo, Luma Ornelas / Alves Braga, Lara Landulfo / Vilas-Boas, Gustavo Sampaio / Oliveira Cardoso, Maiana Santos / Duraes, Andre Rodrigues

Journal of clinical medicine

2023 Volume 12, Issue 8

Abstract: ... neurological manifestations of COVID-19 based on the latest and most up-to-date data available and, thus, promote more ... some conditions and COVID-19 and can better prepare for the most prevalent conditions to associate and ... purposes, cardiovascular and neurological manifestations of SARS-CoV-2 have been classified in three ...

Abstract	A novel coronavirus emerged in China in late 2019 as a disease named coronavirus disease 2019. This pathogen was initially identified as causing a respiratory syndrome, but later, it was found that COVID-19 could also affect other body systems, such as the neurological and cardiovascular systems. For didactic purposes, cardiovascular and neurological manifestations of SARS-CoV-2 have been classified in three different groups: acute complications, late complications, and post-vaccine complications. Therefore, the following study has the goal to summarize and disseminate the present knowledge about the cardiovascular and neurological manifestations of COVID-19 based on the latest and most up-to-date data available and, thus, promote more prepared medical care for these conditions as the medical team is updated. Based on what is brought on this revision and its understanding, the medical service becomes more aware of the causal relationship between some conditions and COVID-19 and can better prepare for the most prevalent conditions to associate and, consequently, to treat patients earlier. Therefore, there is a chance of better prognoses in this context and the need to increase the number of studies about complications related to SARS-CoV-2 infection for a better understanding of other associated conditions.
Language	English
Publishing date	2023-04-12
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12082819
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A Systematic Review Unraveling the Intricate Neurological Spectrum of COVID-19: Manifestations, Complications, and Transformative Insights for Patient Care.

Pitliya, Aakanksha / Dhamecha, Jatin / Kumar, Deepak / Anusha, Kvn / Kancherla, Neeraj / Kumar, Lakshya / Singla, Ramit / Pitliya, Anmol

Neurology India

2024 Volume 72, Issue 1, Page(s) 11–19

Abstract: The coronavirus disease 2019 (COVID-19) pandemic has strained global healthcare and financial ... manifestations and complications associated with COVID-19 and assess their prevalence, impact on patient outcomes ... infrastructures. Neurological manifestations of COVID-19 have gained recognition, emphasizing the need ...

Abstract	The coronavirus disease 2019 (COVID-19) pandemic has strained global healthcare and financial infrastructures. Neurological manifestations of COVID-19 have gained recognition, emphasizing the need for comprehensive research in this area. This systematic review aims to comprehensively examine the neurological manifestations and complications associated with COVID-19 and assess their prevalence, impact on patient outcomes, and potential relationships with comorbidities, while emphasizing the significance of ongoing research in this field. We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 guidelines. A comprehensive search of PubMed, Google Scholar, Science Direct, and ResearchGate databases was conducted to identify eligible studies focusing on COVID-19 patients, reporting neurological symptoms or complications, and published between 2020 and 2022 in English. The data extracted is performed in a Microsoft Excel spreadsheet. Two independent reviewers assessed study quality and bias using the AMSTAR 2 scale before inclusion. This systematic includes 12 systematic reviews and meta-analysis with 191,412 participants and average age of 60 years. Neurological symptoms included headaches, dizziness, anosmia, and ageusia. Complications ranged from cerebrovascular events to Guillain-Barré syndrome. Comorbidities, such as hypertension and diabetes, exacerbated severity. Mortality rates associated with neurological manifestations varied from 29.1% to 84.8%. The study underscores the complex neurological impact of COVID-19, affecting patients across age groups. Ongoing research is vital to understand mechanisms and develop targeted interventions, improving patient care and addressing pandemic consequences. This review provides a holistic view of COVID-19's neurological effects, emphasizing the need for sustained research efforts and collaborative endeavors to combat the neurological issues.
MeSH term(s)	Humans ; COVID-19/complications ; Nervous System Diseases/virology
Language	English
Publishing date	2024-02-29
Publishing country	India
Document type	Journal Article ; Systematic Review
ZDB-ID	415522-1
ISSN	1998-4022 ; 0028-3886
ISSN (online)	1998-4022
ISSN	0028-3886
DOI	10.4103/neurol-india.Neurol-India-D-24-00003
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Article ; Online: Neurological Manifestations in COVID-19 Infection

Collantes, Maria Epifania V. / Espiritu, Adrian I. / Sy, Marie Charmaine C. / Anlacan, Veeda Michelle M. / Jamora, Roland Dominic G.

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques

A Systematic Review and Meta-Analysis

2020 , Page(s) 1–11

Abstract: ... 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 ... This review revealed that neurologic involvement may manifest in COVID-19 infection. What has initially been ...

Abstract	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; I 2 = 77%), “dizziness” (0.08; 0.05–0.12; I 2 = 82%), “headache and dizziness” (0.09; 0.06–0.13; I 2 = 0%), “nausea” (0.07; 0.04–0.11; I 2 = 79%), “vomiting” (0.05; 0.03–0.08; I 2 = 74%), “nausea and vomiting” (0.06; 0.03–0.11; I 2 = 83%), “confusion” (0.05; 0.02–0.14; I 2 = 86%), and “myalgia” (0.21; 0.18–0.25; I 2 = 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.
Keywords	Neurology ; Clinical Neurology ; General Medicine ; covid19
Language	English
Publisher	Cambridge University Press (CUP)
Publishing country	uk
Document type	Article ; Online
ZDB-ID	197622-9
ISSN	0317-1671
ISSN	0317-1671
DOI	10.1017/cjn.2020.146
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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