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Neurological manifestations of patients infected with the SARS-CoV-2: a systematic review of the literature

Abstract : Objective: To perform an updated review of the literature on the neurological manifestations of COVID-19-infected patients METHODS: A PRISMA-guideline-based systematic review was conducted on PubMed, EMBASE, and SCOPUS. Series reporting neurological manifestations of COVID-19 patients were studied. Results: 39 studies and 68,361 laboratory-confirmed COVID-19 patients were included. Up to 21.3% of COVID-19 patients presented neurological symptoms. Headache (5.4%), skeletal muscle injury (5.1%), psychiatric disorders (4.6%), impaired consciousness (2.8%), gustatory/olfactory dysfunction (2.3%), acute cerebrovascular events (1.4%), and dizziness (1.3%), were the most frequently reported neurological manifestations. Ischemic stroke occurred among 1.3% of COVID-19 patients. Other less common neurological manifestations were cranial nerve impairment (0.6%), nerve root and plexus disorders (0.4%), epilepsy (0.7%), and hemorrhagic stroke (0.15%). Impaired consciousness and acute cerebrovascular events were reported in 14% and 4% of patients with a severe disease, respectively, and they were significantly higher compared to non-severe patients (p < 0.05). Individual patient data from 129 COVID-19 patients with acute ischemic stroke (AIS) were extracted: mean age was 64.4 (SD ± 6.2), 78.5% had anterior circulation occlusions, the mean NIHSS was 15 (SD ± 7), and the intra-hospital mortality rate was 22.8%. Admission to the intensive care unit (ICU) was required among 63% of patients. Conclusion: This updated review of literature, shows that headache, skeletal muscle injury, psychiatric disorders, impaired consciousness, and gustatory/olfactory dysfunction were the most common neurological symptoms of COVID-19 patients. Impaired consciousness and acute cerebrovascular events were significantly higher among patients with a severe infection. AIS patients required ICU admission in 63% of cases, while intra-hospital mortality rate was close to 23%.
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Contributeur : Anthony Herrada Connectez-vous pour contacter le contributeur
Soumis le : vendredi 25 juin 2021 - 09:54:27
Dernière modification le : jeudi 19 mai 2022 - 14:56:03

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Federico Cagnazzo, Caroline Arquizan, Imad Derraz, Cyril Dargazanli, Pierre-Henri Lefevre, et al.. Neurological manifestations of patients infected with the SARS-CoV-2: a systematic review of the literature. Journal of Neurology, Springer Verlag, 2020, ⟨10.1007/s00415-020-10285-9⟩. ⟨hal-03270674⟩



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