Neurological manifestations in patients with COVID‐19: A systematic review and meta‐analysis

Abstract

Introduction The intensification of coronavirus disease 2019 (COVID‐19) complications, severe symptoms, and high mortality rate has led researchers to focus on this significant issue. While respiratory and cardiac complications have been described as high‐risk manifestations in patients with COVID‐19, neurological complications can also enhance mortality. This study aimed to evaluate the prevalence of neurological complications arises from SARS‐CoV‐2 and assess the mortality rate from neurological complications. Material and Methods Literature review was conducted by searching in PubMed/Medline, Web of Sciences, and Embase. After performing search strategies with relevant terms, a number of articles were excluded, including review articles, systematic review or meta‐analysis, duplicate publication of same researchers, congress abstracts, animal studies, case reports, case series, and articles reporting a history of neurological features prior to COVID‐19 infection. After retrieving the data, statistical analysis was performed using the STATA Version 14 software. Results From 4455 retrieved publications, 20 articles were selected for further analysis. Among 18,258 included patients, 2791 showed neurological symptoms, which were classified into different groups. Headache, confusion, and fatigue were reported as the most non‐specific neurological features in confirmed COVID‐19 patients. Psychiatric symptoms, CNS disorders, cerebrovascular disorders, CNS inflammatory disorders, PNS disorders, neuromuscular disorders, etc., were defined as specific neurological manifestations. The pooled prevalence of neurological manifestations and mortality rate of COVID‐19 patients with neurological features were estimated to be 23.0% (95% CI: 17.8–29.2) and 29.1% (95% CI: 20.3–39.8), respectively. Conclusion Neurological manifestations may commonly happen in patients with COVID‐19. This study reported a high prevalence of neurological complications and mortality rates in COVID‐19 patients. Therefore, patients with COVID‐19 who indicated neurological symptoms should be taken seriously and should receive early treatment to prevent undesirable events.

Panax ginseng as a potential therapeutic for neurological disorders associated with COVID-19; Toward targeting inflammasome

“…Although SARS-CoV-2 was initially identified as a respiratory virus, it may affect the entire body. While respiratory complications have been considered to be the major risks for COVID-19 patients, neurological complications have also been shown to increase the lethality [ 3 , 4 ]. Neurological damage in COVID-19 patients is triggered by the inflammatory response of cytokines (e.g., IL-6, IL-12, and TNF-α) after the virus binds to angiotensin-converting enzyme 2 (ACE2) receptor and proliferates in the central nervous system (CNS) [ 4 ].…”

“…While respiratory complications have been considered to be the major risks for COVID-19 patients, neurological complications have also been shown to increase the lethality [ 3 , 4 ]. Neurological damage in COVID-19 patients is triggered by the inflammatory response of cytokines (e.g., IL-6, IL-12, and TNF-α) after the virus binds to angiotensin-converting enzyme 2 (ACE2) receptor and proliferates in the central nervous system (CNS) [ 4 ]. Neurological manifestations can be categorized into those in the CNS (vertigo, headache, stroke, anosmia, ataxia, seizure, etc.…”

“…Neurological manifestations can be categorized into those in the CNS (vertigo, headache, stroke, anosmia, ataxia, seizure, etc. ), peripheral nervous system (PNS) (taste/smell/vision impairment and neuropathic pain), and musculoskeletal system [ 4 ].…”

A Comprehensive Review of the Protein Subunit Vaccines Against COVID-19

“…The world has been fighting coronavirus disease 2019 (COVID-19) illness for nearly 2 years ( Koupaei et al, 2022a ; Naimi et al, 2022 ). COVID-19 was induced by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), which emerged in Wuhan, China ( Koupaei et al, 2021 ; Mahdizade Ari et al, 2022 ). Traditional vaccine strategies developed on the basis on attenuated or inactivated pathogens have been demonstrated to be highly efficient for several infectious diseases ( Khoshnood et al, 2022 ).…”

Predictors of fatal neurological complications among admitted COVID-19 patients with their implication in outcome: A Case Control study

“…There are several clinical, laboratory and radiological investigations that can predict the severity of disease and outcome in COVID-19 patients assigned to respiratory complications [ 12 ]. The vast majority of studies on neurological complications, including meta-analyses, focus on the kind of neurological complication and the outcome, while predictors of neurological sequelae are underexplored [ 13 , 14 ], but there are hardly any relevant predictors for neurological sequelae. So, we designed an observational study at COVID-19 High Dependency Unit of tertiary care hospital to investigate possible predicting factors that may put COVID-19 patients at risk of developing serious neurological complications, as well as to observe any impact of complications and predictors on patients’ outcome.…”