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Clinical manifestations and evidence of neurological involvement in 2019 novel coronavirus SARS-CoV-2: a systematic review and meta-analysis

BACKGROUND: Coronavirus disease 2019 (COVID-19) has become a global pandemic, affecting millions of people. However, clinical research on its neurological manifestations is thus far limited. In this study, we aimed to systematically collect and investigate the clinical manifestations and evidence of...

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Autores principales: Wang, Lei, Shen, Yin, Li, Man, Chuang, Haoyu, Ye, Youfan, Zhao, Hongyang, Wang, Haijun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288253/
https://www.ncbi.nlm.nih.gov/pubmed/32529575
http://dx.doi.org/10.1007/s00415-020-09974-2
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author Wang, Lei
Shen, Yin
Li, Man
Chuang, Haoyu
Ye, Youfan
Zhao, Hongyang
Wang, Haijun
author_facet Wang, Lei
Shen, Yin
Li, Man
Chuang, Haoyu
Ye, Youfan
Zhao, Hongyang
Wang, Haijun
author_sort Wang, Lei
collection PubMed
description BACKGROUND: Coronavirus disease 2019 (COVID-19) has become a global pandemic, affecting millions of people. However, clinical research on its neurological manifestations is thus far limited. In this study, we aimed to systematically collect and investigate the clinical manifestations and evidence of neurological involvement in COVID-19. METHODS: Three medical (Medline, Embase, and Scopus) and two preprints (BioRxiv and MedRxiv) databases were systematically searched for all published articles on neurological involvement in COVID-19 since the outbreak. All included studies were systematically reviewed, and selected clinical data were collected for meta-analysis via random-effects. RESULTS: A total of 41 articles were eligible and included in this review, showing a wide spectrum of neurological manifestations in COVID-19. The meta-analysis for unspecific neurological symptoms revealed that the most common manifestations were fatigue (33.2% [23.1–43.3]), anorexia (30.0% [23.2–36.9]), dyspnea/shortness of breath (26.9% [19.2–34.6]), and malaise (26.7% [13.3–40.1]). The common specific neurological symptoms included olfactory (35.7–85.6%) and gustatory (33.3–88.8%) disorders, especially in mild cases. Guillain–Barré syndrome and acute inflammation of the brain, spinal cord, and meninges were repeatedly reported after COVID-19. Laboratory, electrophysiological, radiological, and pathological evidence supported neurologic involvement of COVID-19. CONCLUSIONS: Neurological manifestations are various and prevalent in COVID-19. Emerging clinical evidence suggests neurological involvement is an important aspect of the disease. The underlying mechanisms can include both direct invasion and maladaptive inflammatory responses. More studies should be conducted to explore the role of neurological manifestations in COVID-19 progression and to verify their underlying mechanisms. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00415-020-09974-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-72882532020-06-11 Clinical manifestations and evidence of neurological involvement in 2019 novel coronavirus SARS-CoV-2: a systematic review and meta-analysis Wang, Lei Shen, Yin Li, Man Chuang, Haoyu Ye, Youfan Zhao, Hongyang Wang, Haijun J Neurol Review BACKGROUND: Coronavirus disease 2019 (COVID-19) has become a global pandemic, affecting millions of people. However, clinical research on its neurological manifestations is thus far limited. In this study, we aimed to systematically collect and investigate the clinical manifestations and evidence of neurological involvement in COVID-19. METHODS: Three medical (Medline, Embase, and Scopus) and two preprints (BioRxiv and MedRxiv) databases were systematically searched for all published articles on neurological involvement in COVID-19 since the outbreak. All included studies were systematically reviewed, and selected clinical data were collected for meta-analysis via random-effects. RESULTS: A total of 41 articles were eligible and included in this review, showing a wide spectrum of neurological manifestations in COVID-19. The meta-analysis for unspecific neurological symptoms revealed that the most common manifestations were fatigue (33.2% [23.1–43.3]), anorexia (30.0% [23.2–36.9]), dyspnea/shortness of breath (26.9% [19.2–34.6]), and malaise (26.7% [13.3–40.1]). The common specific neurological symptoms included olfactory (35.7–85.6%) and gustatory (33.3–88.8%) disorders, especially in mild cases. Guillain–Barré syndrome and acute inflammation of the brain, spinal cord, and meninges were repeatedly reported after COVID-19. Laboratory, electrophysiological, radiological, and pathological evidence supported neurologic involvement of COVID-19. CONCLUSIONS: Neurological manifestations are various and prevalent in COVID-19. Emerging clinical evidence suggests neurological involvement is an important aspect of the disease. The underlying mechanisms can include both direct invasion and maladaptive inflammatory responses. More studies should be conducted to explore the role of neurological manifestations in COVID-19 progression and to verify their underlying mechanisms. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00415-020-09974-2) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2020-06-11 2020 /pmc/articles/PMC7288253/ /pubmed/32529575 http://dx.doi.org/10.1007/s00415-020-09974-2 Text en © Springer-Verlag GmbH Germany, part of Springer Nature 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Review
Wang, Lei
Shen, Yin
Li, Man
Chuang, Haoyu
Ye, Youfan
Zhao, Hongyang
Wang, Haijun
Clinical manifestations and evidence of neurological involvement in 2019 novel coronavirus SARS-CoV-2: a systematic review and meta-analysis
title Clinical manifestations and evidence of neurological involvement in 2019 novel coronavirus SARS-CoV-2: a systematic review and meta-analysis
title_full Clinical manifestations and evidence of neurological involvement in 2019 novel coronavirus SARS-CoV-2: a systematic review and meta-analysis
title_fullStr Clinical manifestations and evidence of neurological involvement in 2019 novel coronavirus SARS-CoV-2: a systematic review and meta-analysis
title_full_unstemmed Clinical manifestations and evidence of neurological involvement in 2019 novel coronavirus SARS-CoV-2: a systematic review and meta-analysis
title_short Clinical manifestations and evidence of neurological involvement in 2019 novel coronavirus SARS-CoV-2: a systematic review and meta-analysis
title_sort clinical manifestations and evidence of neurological involvement in 2019 novel coronavirus sars-cov-2: a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288253/
https://www.ncbi.nlm.nih.gov/pubmed/32529575
http://dx.doi.org/10.1007/s00415-020-09974-2
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