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1.
Can J Neurol Sci ; 48(1): 66-76, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-646255

ABSTRACT

BACKGROUND: Growing evidence showed that coronavirus disease 2019 (COVID-19) infection may present with neurological manifestations. This review aimed to determine the neurological manifestations and complications in COVID-19. METHODS: We conducted a systematic review and meta-analysis that included cohort and case series/reports involving a population of patients confirmed with COVID-19 infection and their neurologic manifestations. We searched the following electronic databases until April 18, 2020: PubMed, Embase, Scopus, and World Health Organization database (PROSPERO registration number: CRD42020180658). RESULTS: From 403 articles identified, 49 studies involving a total of 6,335 confirmed COVID-19 cases were included. The random-effects modeling analysis for each neurological symptom showed the following proportional point estimates with 95% confidence intervals: "headache" (0.12; 0.10-0.14; I2 = 77%), "dizziness" (0.08; 0.05-0.12; I2 = 82%), "headache and dizziness" (0.09; 0.06-0.13; I2 = 0%), "nausea" (0.07; 0.04-0.11; I2 = 79%), "vomiting" (0.05; 0.03-0.08; I2 = 74%), "nausea and vomiting" (0.06; 0.03-0.11; I2 = 83%), "confusion" (0.05; 0.02-0.14; I2 = 86%), and "myalgia" (0.21; 0.18-0.25; I2 = 85%). The most common neurological complication associated with COVID-19 infection was vascular disorders (n = 23); other associated conditions were encephalopathy (n = 3), encephalitis (n = 1), oculomotor nerve palsy (n = 1), isolated sudden-onset anosmia (n = 1), Guillain-Barré syndrome (n = 1), and Miller-Fisher syndrome (n = 2). Most patients with neurological complications survived (n = 14); a considerable number of patients died (n = 7); and the rest had unclear outcomes (n = 12). CONCLUSION: This review revealed that neurologic involvement may manifest in COVID-19 infection. What has initially been thought of as a primarily respiratory illness has evolved into a wide-ranging multi-organ disease.


Subject(s)
COVID-19/physiopathology , Cerebrovascular Disorders/physiopathology , Headache/physiopathology , Myalgia/physiopathology , Anosmia/etiology , Anosmia/physiopathology , Brain Diseases/etiology , Brain Diseases/physiopathology , COVID-19/complications , Cerebral Hemorrhage/etiology , Cerebral Hemorrhage/physiopathology , Cerebral Infarction/etiology , Cerebral Infarction/physiopathology , Cerebrovascular Disorders/etiology , Confusion/etiology , Confusion/physiopathology , Dizziness/etiology , Dizziness/physiopathology , Encephalitis/etiology , Encephalitis/physiopathology , Guillain-Barre Syndrome/etiology , Guillain-Barre Syndrome/physiopathology , Headache/etiology , Humans , Myalgia/etiology , Nausea/etiology , Nausea/physiopathology , Oculomotor Nerve Diseases/etiology , Oculomotor Nerve Diseases/physiopathology , SARS-CoV-2 , Sinus Thrombosis, Intracranial/etiology , Sinus Thrombosis, Intracranial/physiopathology , Vomiting/etiology , Vomiting/physiopathology
2.
Neurology ; 95(10): 454-457, 2020 09 08.
Article in English | MEDLINE | ID: covidwho-616669
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