Neurological manifestations of COVID-19: a systematic review.

Autor: Nepal G; Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Kathmandu, Nepal., Rehrig JH; University of New England College of Osteopathic Medicine, Biddeford, ME, USA., Shrestha GS; Department of Anesthesiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. gentlesunder@hotmail.com., Shing YK; National University Hospital, Singapore, Singapore., Yadav JK; Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Kathmandu, Nepal., Ojha R; Department of Neurology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal., Pokhrel G; Department of Urology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China., Tu ZL; Department of Neurology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China., Huang DY; Department of Neurology, Shanghai East Hospital of Tongji University School of Medicine, Shanghai, China.
Jazyk: angličtina
Zdroj: Critical care (London, England) [Crit Care] 2020 Jul 13; Vol. 24 (1), pp. 421. Date of Electronic Publication: 2020 Jul 13.
DOI: 10.1186/s13054-020-03121-z
Abstrakt: 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.
Databáze: MEDLINE
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