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Open Access 01-12-2020 | Guillain-Barré Syndrome | Research

Neurological manifestations of COVID-19: a systematic review

Authors: Gaurav Nepal, Jessica Holly Rehrig, Gentle Sunder Shrestha, Yow Ka Shing, Jayant Kumar Yadav, Rajeev Ojha, Gaurab Pokhrel, Zhi Lan Tu, Dong Ya Huang

Published in: Critical Care | Issue 1/2020

Abstract

Introduction

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the global spread of coronavirus disease (COVID-19). Our understanding of the impact this virus has on the nervous system is limited. Our review aims to inform and improve decision-making among the physicians treating COVID-19 by presenting a systematic analysis of the neurological manifestations experienced within these patients.

Methods

Any study, released prior to May 20, 2020, that reported neurological manifestations in patients infected by SARS-CoV-2 was systematically reviewed using the PRISMA (Preferred Reporting Items for Systemic review and Meta-Analysis) statement.

Results

Our systematic review included data from 37 articles: twelve retrospective studies, two prospective studies, and the rest case reports/series. The most commonly reported neurological manifestations of COVID-19 were myalgia, headache, altered sensorium, hyposmia, and hypogeusia. Uncommonly, COVID-19 can also present with central nervous system manifestations such as ischemic stroke, intracerebral hemorrhage, encephalo-myelitis, and acute myelitis, peripheral nervous manifestations such as Guillain-Barré syndrome and Bell’s palsy, and skeletal muscle manifestations such as rhabdomyolysis.

Conclusion

While COVID-19 typically presents as a self-limiting respiratory disease, it has been reported in up to 20% of patients to progress to severe illness with multi-organ involvement. The neurological manifestations of COVID-19 are not uncommon, but our study found most resolve with treatment of the underlying infection. Although the timeliness of this review engages current challenges posed by the COVID-19 pandemic, readers must not ignore the limitations and biases intrinsic to an early investigation.

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Title: Neurological manifestations of COVID-19: a systematic review
Authors: Gaurav Nepal
Jessica Holly Rehrig
Gentle Sunder Shrestha
Yow Ka Shing
Jayant Kumar Yadav
Rajeev Ojha
Gaurab Pokhrel
Zhi Lan Tu
Dong Ya Huang
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Guillain-Barré Syndrome
Stroke
Myalgie
Myalgia
SARS-CoV-2
COVID-19
Headache
Published in: Critical Care / Issue 1/2020
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-020-03121-z

At a glance: The STEP trials

Springer Medicine

Neurological manifestations of COVID-19: a systematic review

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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