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Brain Inj
. 2020 Oct 19;1-20.
doi: 10.1080/02699052.2020.1831606. Online ahead of print.
Neurological manifestations in COVID-19: a systematic review and meta-analysis
Tzy Harn Chua 1 , Zheyu Xu 2 , Nicolas Kon Kam King 3 4
Affiliations
- PMID: 33074036
- DOI: 10.1080/02699052.2020.1831606
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-Barr? 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.
Keywords: COVID-19; Guillain-Barr? syndrome; cerebrovascular; encephalitis; neurological.