The neurology and neuropsychiatry of COVID-19: a systematic review and meta-analysis of the early literature reveals frequent CNS manifestations and key emerging narratives



Rogers, Jonathan ORCID: 0000-0002-4671-5410, Watson, Cameron ORCID: 0000-0003-2346-4636, Badenoch, James ORCID: 0000-0002-6994-6916, Cross, Benjamin, Butler, Matthew ORCID: 0000-0002-9734-6539, Song, Jia, Hafeez, Danish, Morrin, Hamilton ORCID: 0000-0002-7801-0212, Rengasamy, Emma Rachel ORCID: 0000-0001-7059-9627, Thomas, Lucretia
et al (show 20 more authors) (2021) The neurology and neuropsychiatry of COVID-19: a systematic review and meta-analysis of the early literature reveals frequent CNS manifestations and key emerging narratives.

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Abstract

<h4>ABSTRACT</h4> <h4>Objectives</h4> There is accumulating evidence of the neurological and neuropsychiatric features of infection with SARS-CoV-2. In this systematic review and meta-analysis, we aimed to describe the characteristics of the early literature and estimate point prevalences for neurological and neuropsychiatric manifestations. <h4>Methods</h4> We searched MEDLINE, Embase, PsycInfo and CINAHL up to 18 July 2020 for randomised controlled trials, cohort studies, case-control studies, cross-sectional studies and case series. Studies reporting prevalences of neurological or neuropsychiatric symptoms were synthesised into meta-analyses to estimate pooled prevalence. <h4>Results</h4> 13,292 records were screened by at least two authors to identify 215 included studies, of which there were 37 cohort studies, 15 case-control studies, 80 cross-sectional studies and 83 case series from 30 countries. 147 studies were included in the meta-analysis. The symptoms with the highest prevalence were anosmia (43.1% [35.2—51.3], n =15,975, 63 studies), weakness (40.0% [27.9—53.5], n =221, 3 studies), fatigue (37.8% [31.6—44.4], n =21,101, 67 studies), dysgeusia (37.2% [30.0—45.3], n =13,686, 52 studies), myalgia (25.1% [19.8—31.3], n =66.268, 76 studies), depression (23.0 % [11.8—40.2], n =43,128, 10 studies), headache (20.7% [95% CI 16.1—26.1], n =64,613, 84 studies), anxiety (15.9% [5.6—37.7], n =42,566, 9 studies) and altered mental status (8.2% [4.4—14.8], n =49,326, 19 studies). Heterogeneity for most clinical manifestations was high. <h4>Conclusions</h4> Neurological and neuropsychiatric symptoms of COVID-19 in the pandemic’s early phase are varied and common. The neurological and psychiatric academic communities should develop systems to facilitate high-quality methodologies, including more rapid examination of the longitudinal course of neuropsychiatric complications of newly emerging diseases and their relationship to neuroimaging and inflammatory biomarkers.

Item Type: Article
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 09 Nov 2021 13:18
Last Modified: 05 Oct 2022 20:30
DOI: 10.1101/2021.02.24.21252335
Open Access URL: https://www.medrxiv.org/content/10.1101/2021.02.24...
URI: https://livrepository.liverpool.ac.uk/id/eprint/3142966