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. 2021 May;268(5):1561-1569.
doi: 10.1007/s00415-020-09978-y. Epub 2020 Aug 1.

Exploring the clinical association between neurological symptoms and COVID-19 pandemic outbreak: a systematic review of current literature

Davide Tiziano Di Carlo  1   2 , Nicola Montemurro  1   2 , Giandomenico Petrella  1   2 , Gabriele Siciliano  3 , Roberto Ceravolo  3 , Paolo Perrini  4   5
Affiliations

Exploring the clinical association between neurological symptoms and COVID-19 pandemic outbreak: a systematic review of current literature

Davide Tiziano Di Carlo et al. J Neurol. 2021 May.

Abstract

Object: The novel severe acute respiratory syndrome (SARS)-CoV-2 outbreak has been declared a pandemic in March, 2020. An increasing body of evidence suggests that patients with the coronavirus disease (COVID-19) might have a heterogeneous spectrum of neurological symptoms METHODS: A systematic search of two databases was performed for studies published up to May 29th, 2020. PRISMA guidelines were followed.

Results: We included 19 studies evaluating 12,157 patients with laboratory-confirmed COVID-19 infections. The median age of patients was 50.3 (IQR 11.9), and the rate of male patients was 50.6% (95% CI 49.2-51.6%). The most common reported comorbidities were hypertension and diabetes (31.1%, 95% CI 30-32.3% and 13.5%, 95% CI 12.3-14.8%, respectively). Headache was reported in 7.5% of patients (95% CI 6.6-8.4%), and dizziness in 6.1% (95% CI 5.1-7.1%). Hypo/anosmia, and gustatory dysfunction were reported in 46.8 and 52.3%, of patients, respectively. Symptoms related to muscular injury ranged between 15 and 30%. Three studies reported radiological confirmed acute cerebrovascular disease in 2% of patients (95% CI 1.6-2.4%).

Conclusions: These data support accumulating evidence that a significant proportion of patients with COVID-19 infection develop neurological manifestations, especially olfactory, and gustatory dysfunction. The pathophysiology of this association is under investigation and warrants additional studies, Physicians should be aware of this possible association because during the epidemic period of COVID-19, early recognition of neurologic manifestations otherwise not explained would raise the suspect of acute respiratory syndrome coronavirus 2 infection.

Keywords: COVID-19; Coronavirus; Neurological symptoms; SARS-CoV-2; β-coronavirus.

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Conflict of interest statement

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
PRISMA diagram detailing the specifics of the systematic literature review
See this image and copyright information in PMC

References

    1. Lu H, Stratton CW, Tang Y. Outbreak of Pneumonia of Unknown Etiology in Wuhan China: the Mystery and the Miracle. J Med Virol. 2020;92(4):401–402. doi: 10.1002/jmv.25678. - DOI - PMC - PubMed
    1. Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, et al. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect Dis. 2013;13:752–761. doi: 10.1016/S1473-3099(13)70204-4. - DOI - PMC - PubMed
    1. Peiris JSM, Lai ST, Poon LLM, et al. Coronavirus as a possible cause of severe acute respiratory syndrome. Lancet. 2003;361:1319–1325. doi: 10.1016/S0140-6736(03)13077-2. - DOI - PMC - PubMed
    1. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 doi: 10.1016/S0140-6736(20)30211-7. - DOI - PMC - PubMed
    1. World Health Organization. Coronavirus disease 2019 (COVID-19) situation report. Accessed April 20, 2020

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