A systematic review of neurological symptoms and complications of COVID-19

Chen, Xiangliang, Laurent, Sarah, Onur, Oezguer A., Kleineberg, Nina N., Fink, Gereon R. ORCID: 0000-0002-8230-1856, Schweitzer, Finja and Warnke, Clemens ORCID: 0000-0002-3510-9255 . A systematic review of neurological symptoms and complications of COVID-19. J. Neurol.. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1432-1459

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DOI:10.1007/s00415-020-10067-3

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.

Item Type:

Journal Article

Creators:

Creators	Email	ORCID	ORCID Put Code
Chen, Xiangliang	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Laurent, Sarah	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Onur, Oezguer A.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Kleineberg, Nina N.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Fink, Gereon R.	UNSPECIFIED	orcid.org/0000-0002-8230-1856	UNSPECIFIED
Schweitzer, Finja	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Warnke, Clemens	UNSPECIFIED	orcid.org/0000-0002-3510-9255	UNSPECIFIED