ABSTRACT
[Objective] The systematic review aims to examine the association between COVID-19 and cognitive dysfunction, including the link between the severity of COVID-19 and the occurrence of cognitive impairment and the potential pathophysiological mechanisms related to brain fog among COVID-19 patients. [Methods] PubMed, Oxford University Press, ProQuest Health and Medical Complete, ScienceDirect, Ovid, HERDIN, Google Scholar, and Cochrane Library databases were accessed to retrieve literature using the PRISMA guidelines. [Results] After critical appraisal, 13 full journal articles were included in the study. The studies showed the most frequent cognitive impairment are attention, memory, and executive function in COVID-19 patients. Compared with healthy controls in three out of four studies, cognitive impairment was only evident in COVID-19 patients. Furthermore, two studies showed no correlation between brain fog and depression, and five studies showed a link between the severity of COVID-19 infection and cognitive impairment. Cases ranging from mild to severe illness presented manifestations of brain fog. However, a disparity in the evidence of the pathophysiology of COVID-19 and cognitive dysfunction exists, prompting the need to investigate further. Additionally, recent studies provide insufficient evidence for direct central nervous system invasion, and there are emerging studies that contrast the presumed pathogenesis of neurological complications from neuroinflammation. [Conclusion] There is an association between COVID-19 and cognitive dysfunction. Manifestation of cognitive dysfunction is present regardless of illness severity. Moreover, there are existing pathophysiological mechanisms of the Coronavirus that lead to cognitive dysfunction in COVID-19 patients;however, additional studies are required to substantiate such mechanisms further. [PROSPERO registration number] CRD42022325669. © 2022, Department of Science and Technology. All rights reserved.
ABSTRACT
Introduction COVID-19 is a global pandemic caused by the SARS-CoV-2 virus. Although most COVID-19 cases are asymptomatic or mild, a significant number of patients experienced adverse outcomes. In addition, studies have shown that cardiac abnormalities are associated with increased mortality in hospitalised patients with COVID-19. This finding sets a precedent for the potential use of ECG tracing as an indicator of patient mortality and morbidity. This study aims to determine associations between the 12-lead ECG findings and various clinical outcomes of hospitalised patients with COVID-19, measured as incidence of endotracheal intubation, intensive care unit (ICU) admission and mortality rate. Methods and analysis An electronic literature search will identify all potentially relevant articles using specific databases and websites. The search will be limited to studies published from December 2019 to May 2021. In addition, studies will include hospitalised patients with COVID-19 with normal and abnormal 12-lead ECG findings assessed for clinical outcomes, including the incidence of endotracheal intubation, ICU admission and mortality rate. The risk of bias in individual studies will be evaluated using the Quality in Prognostic Studies tool or the Cochrane risk of bias tool. A meta-analysis will be conducted if at least two studies indicate a prognostic factor's effect. Moreover, subgroup and sensitivity analyses will be performed accordingly to address heterogeneity. Reporting the review results will comply with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. The quality of evidence generated will be assessed using the Grades of Recommendation, Assessment, Development and Evaluation system. Ethics and dissemination This study has been exempted from ethics review. There will be no patient or public involvement in this study. Furthermore, the findings will be disseminated via conferences, seminars, symposia and congresses on top of peer-reviewed journals. PROSPERO registration number CRD42021257155.