AI Article Synopsis
- One year into the COVID-19 pandemic, researchers summarized the neurologic symptoms occurring in COVID-19 patients and investigated their connection to disease severity and mortality.
- They analyzed 350 studies involving over 145,000 patients, identifying 41 neurologic manifestations, with common symptoms including fatigue, myalgia, and taste impairment.
- They found that neurologic symptoms were prevalent, particularly in older patients, and the presence of these symptoms significantly increased the risk of mortality, especially in those aged over 60 years.
Article Abstract
Background And Objectives: One year after the onset of the coronavirus disease 2019 (COVID-19) pandemic, we aimed to summarize the frequency of neurologic manifestations reported in patients with COVID-19 and to investigate the association of these manifestations with disease severity and mortality.
Methods: We searched PubMed, Medline, Cochrane library, ClinicalTrials.gov, and EMBASE for studies from December 31, 2019, to December 15, 2020, enrolling consecutive patients with COVID-19 presenting with neurologic manifestations. Risk of bias was examined with the Joanna Briggs Institute scale. A random-effects meta-analysis was performed, and pooled prevalence and 95% confidence intervals (CIs) were calculated for neurologic manifestations. Odds ratio (ORs) and 95% CIs were calculated to determine the association of neurologic manifestations with disease severity and mortality. Presence of heterogeneity was assessed with , meta-regression, and subgroup analyses. Statistical analyses were conducted in R version 3.6.2.
Results: Of 2,455 citations, 350 studies were included in this review, providing data on 145,721 patients with COVID-19, 89% of whom were hospitalized. Forty-one neurologic manifestations (24 symptoms and 17 diagnoses) were identified. Pooled prevalence of the most common neurologic symptoms included fatigue (32%), myalgia (20%), taste impairment (21%), smell impairment (19%), and headache (13%). A low risk of bias was observed in 85% of studies; studies with higher risk of bias yielded higher prevalence estimates. Stroke was the most common neurologic diagnosis (pooled prevalence 2%). In patients with COVID-19 ≥60 years of age, the pooled prevalence of acute confusion/delirium was 34%, and the presence of any neurologic manifestations in this age group was associated with mortality (OR 1.80, 95% CI 1.11-2.91).
Discussion: Up to one-third of patients with COVID-19 analyzed in this review experienced at least 1 neurologic manifestation. One in 50 patients experienced stroke. In those >60 years of age, more than one-third had acute confusion/delirium; the presence of neurologic manifestations in this group was associated with nearly a doubling of mortality. Results must be interpreted with the limitations of observational studies and associated bias in mind.
Systematic Review Registration: PROSPERO CRD42020181867.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8665434 | PMC |
| http://dx.doi.org/10.1212/WNL.0000000000012930 | DOI Listing |
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