Persistent neuropsychiatric symptoms after COVID-19: a systematic review and meta-analysis.



Badenoch, James B ORCID: 0000-0002-6994-6916, Rengasamy, Emma R, Watson, Cameron, Jansen, Katrin, Chakraborty, Stuti, Sundaram, Ritika D, Hafeez, Danish ORCID: 0000-0003-3712-136X, Burchill, Ella ORCID: 0000-0002-1674-8844, Saini, Aman, Thomas, Lucretia
et al (show 13 more authors) (2022) Persistent neuropsychiatric symptoms after COVID-19: a systematic review and meta-analysis. Brain communications, 4 (1). fcab297 - ?.

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Abstract

The nature and extent of persistent neuropsychiatric symptoms after COVID-19 are not established. To help inform mental health service planning in the pandemic recovery phase, we systematically determined the prevalence of neuropsychiatric symptoms in survivors of COVID-19. For this pre-registered systematic review and meta-analysis (PROSPERO ID CRD42021239750), we searched MEDLINE, EMBASE, CINAHL and PsycINFO to 20 February 2021, plus our own curated database. We included peer-reviewed studies reporting neuropsychiatric symptoms at post-acute or later time-points after COVID-19 infection and in control groups where available. For each study, a minimum of two authors extracted summary data. For each symptom, we calculated a pooled prevalence using generalized linear mixed models. Heterogeneity was measured with <i>I</i> <sup>2</sup>. Subgroup analyses were conducted for COVID-19 hospitalization, severity and duration of follow-up. From 2844 unique titles, we included 51 studies (<i>n </i>= 18 917 patients). The mean duration of follow-up after COVID-19 was 77 days (range 14-182 days). Study quality was most commonly moderate. The most prevalent neuropsychiatric symptom was sleep disturbance [pooled prevalence = 27.4% (95% confidence interval 21.4-34.4%)], followed by fatigue [24.4% (17.5-32.9%)], objective cognitive impairment [20.2% (10.3-35.7%)], anxiety [19.1% (13.3-26.8%)] and post-traumatic stress [15.7% (9.9-24.1%)]. Only two studies reported symptoms in control groups, both reporting higher frequencies in COVID-19 survivors versus controls. Between-study heterogeneity was high (<i>I</i> <sup>2 </sup>= 79.6-98.6%). There was little or no evidence of differential symptom prevalence based on hospitalization status, severity or follow-up duration. Neuropsychiatric symptoms are common and persistent after recovery from COVID-19. The literature on longer-term consequences is still maturing but indicates a particularly high prevalence of insomnia, fatigue, cognitive impairment and anxiety disorders in the first 6 months after infection.

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: 10 Jun 2022 14:09
Last Modified: 01 Sep 2022 21:10
DOI: 10.1093/braincomms/fcab297
URI: https://livrepository.liverpool.ac.uk/id/eprint/3156190