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Open Access 01-02-2021 | SARS-CoV-2 | Review

A systematic review of neurological symptoms and complications of COVID-19

Authors: Xiangliang Chen, Sarah Laurent, Oezguer A. Onur, Nina N. Kleineberg, Gereon R. Fink, Finja Schweitzer, Clemens Warnke

Published in: Journal of Neurology | Issue 2/2021

Abstract

Objective

To study the frequency of neurological symptoms and complications in COVID-19 patients in a systematic review of the literature.

Methods

Relevant studies were identified through electronic explorations of PubMed, medRxiv, and bioRxiv. Besides, three Chinese databases were searched. A snowballing method searching the bibliographies of the retrieved references was applied to identify potentially relevant articles. Articles published within 1 year prior to April 20th, 2020, were screened with no language restriction imposed. Databases were searched for terms related to SARS-CoV-2/COVID-19 and neurological manifestations, using a pre-established protocol registered on the International Prospective Register of Systematic Reviews database (ID: CRD42020187994).

Results

A total of 2441 articles were screened for relevant content, of which 92 full-text publications were included in the analyses of neurological manifestations of COVID-19. Headache, dizziness, taste and smell dysfunctions, and impaired consciousness were the most frequently described neurological symptoms, the latter more often among patients with a severe or critical disease course. To date, only smaller cohort studies or single cases have reported cerebrovascular events, seizures, meningoencephalitis, and immune-mediated neurological diseases, not suitable for quantitative analysis.

Conclusion

The most frequent neurological symptoms reported in association with COVID-19 are non-specific for the infection with SARS-CoV-2. Although SARS-CoV-2 may have the potential to gain direct access to the nervous system, so far, SARS-CoV-2 was detected in the cerebrospinal fluid in two cases only. Standardized international registries are needed to clarify the clinical relevance of the neuropathogenicity of SARS-CoV-2 and to elucidate a possible impact of SARS-CoV-2 infection on common neurological disease, such as Alzheimer’s, Parkinson’s disease or multiple sclerosis.

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Title: A systematic review of neurological symptoms and complications of COVID-19
Authors: Xiangliang Chen
Sarah Laurent
Oezguer A. Onur
Nina N. Kleineberg
Gereon R. Fink
Finja Schweitzer
Clemens Warnke
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Keywords: SARS-CoV-2
COVID-19
Headache
Encephalitis
Published in: Journal of Neurology / Issue 2/2021
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-10067-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A systematic review of neurological symptoms and complications of COVID-19

Abstract

Objective

Methods

Results

Conclusion

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Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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