ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic has strained global healthcare and financial infrastructures. Neurological manifestations of COVID-19 have gained recognition, emphasizing the need for comprehensive research in this area. This systematic review aims to comprehensively examine the neurological manifestations and complications associated with COVID-19 and assess their prevalence, impact on patient outcomes, and potential relationships with comorbidities, while emphasizing the significance of ongoing research in this field. We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 guidelines. A comprehensive search of PubMed, Google Scholar, Science Direct, and ResearchGate databases was conducted to identify eligible studies focusing on COVID-19 patients, reporting neurological symptoms or complications, and published between 2020 and 2022 in English. The data extracted is performed in a Microsoft Excel spreadsheet. Two independent reviewers assessed study quality and bias using the AMSTAR 2 scale before inclusion. This systematic includes 12 systematic reviews and meta-analysis with 191,412 participants and average age of 60 years. Neurological symptoms included headaches, dizziness, anosmia, and ageusia. Complications ranged from cerebrovascular events to Guillain-Barré syndrome. Comorbidities, such as hypertension and diabetes, exacerbated severity. Mortality rates associated with neurological manifestations varied from 29.1% to 84.8%. The study underscores the complex neurological impact of COVID-19, affecting patients across age groups. Ongoing research is vital to understand mechanisms and develop targeted interventions, improving patient care and addressing pandemic consequences. This review provides a holistic view of COVID-19's neurological effects, emphasizing the need for sustained research efforts and collaborative endeavors to combat the neurological issues.
Subject(s)
COVID-19 , Nervous System Diseases , Humans , COVID-19/complications , Nervous System Diseases/virologyABSTRACT
Background: Diabetic peripheral neuropathy (DPN) is common microvascular complication with lack of data from many regions. Vibration perception threshold (VPT) is an objective tool to screen vibration-based neuropathy both quantitatively and qualitatively. We studied prevalence that correlates VPT in diabetic sample population. Methods: A cross-sectional study was performed in 100 under treatment urban type 2 diabetics. Using bioesthesiometer, we tested VPT from sole of lower limbs of each participant. VPT >25 was considered as DPN. VPT was further correlated to determinants using t test, chi square, and multiple linear regressions. P < 0.05 was taken as statistically significant. Results: Mean age was 57, mean duration was 9.42 years, 40% were good glycemic, 28% were symptomatic for neuropathy, half subjects had co-existing hypertension and positive family history. VPT >25 was prevalent in 38% participants and mild, moderate, severe grades of DPN were present in 10%, 20%, 38%, respectively. VPT was associated with all three measures of glycemic control both quantitatively and qualitatively imposing significant odds risk (3.45, 2.63, 3.63 for HbA1C, FPG, 2hPG, respectively). Presence of symptoms, duration, and family history were significant predictors of VPT, whereas age, gender, hypertension, hyperlipidemia, and glycemic control were not. Conclusion: In chronic type 2 diabetics from a city Gujarat, we report 38% prevalence of DPN, related to symptoms, duration, family history, and all measures of glycemic triad. Unrelated to age and gender, VPT is superior to symptoms to detect DPN and it should be used optimally to insinuate timely preventive measures.
