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2020 ; 24
(1
): 421
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Neurological manifestations of COVID-19: a systematic review
#MMPMID32660520
Nepal G
; Rehrig JH
; Shrestha GS
; Shing YK
; Yadav JK
; Ojha R
; Pokhrel G
; Tu ZL
; Huang DY
Crit Care
2020[Jul]; 24
(1
): 421
PMID32660520
show ga
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.