Neurological manifestations of COVID-19: A systematic review

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 one 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. Conclusions: 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.

Maternal COVID-19 and neonatal hearing loss: a multicentric survey

“…Although these primary results do not indicate any immediate effect of SARS-COV-2 maternal infection on neonatal hearing, more children need to be tested and followed up over an extended period of time to detect any possible delayed effects [6,7]. Early automated ABR rather than TOEA only may detect auditory neuropathy as one of the neuropathic effects of the virus.…”

“…Neurological affections have been reported during infections by the novel SARS-COV-2 virus. These include affections of smell, taste, hearing and balance, Bell's palsy, encephalitis, ischemic stroke, intracerebral hemorrhage, Guillain-Barre syndrome and a multitude of other more subtle manifestations [1][2][3][4][5][6][7]. With the evolution and persistence of the pandemic, pregnancies and deliveries were inevitable.…”

RIG-I-induced innate antiviral immunity protects mice from lethal SARS-CoV-2 infection

“…The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has called to attention the vital importance of rapid, effective strategies for limiting the spread of emerging viruses. SARS-CoV-2 is the etiological agent of Coronavirus Disease 2019 (COVID-19) 1,2 , which infects the upper and lower airways of patients but also can cause neurological symptoms, in particular anosmia 3,4 . The clinical course of COVID-19 is extremely variable between individuals, from mild symptoms to severe interstitial pneumonia requiring mechanical ventilation.…”