ABSTRACT

Objective

Following the outbreak of coronavirus 2019 (COVID-19), there is strong evidence of neurological involvement in these patients. We aimed to determine the clinical characteristics of neurological manifestations in COVID-19.

Method

A systematic review of studies reporting neurological manifestations published between 1 December, 2019 and 11 May, 2020 was performed. Studies were grouped based on neurological manifestation. Pooled analyses of individual patient’s clinical characteristics and olfactory and gustatory dysfunction prevalence were performed.

Results

Of 486 studies identified, 48 were included. 70 patients with 73 neurological manifestations were reported. 39 (53.4%) patients had stroke, 18 (24.7%) had Guillain-Barré syndrome and variants, 11 (15.1%) had meningitis, encephalitis, encephalopathy, or myelitis, and five (6.8%) had seizures. They had a mean age of 61.9 ± 17.7 years (60.6% male). Neurological disease occurred 8.1 ± 6.8 days from initial symptoms. Average mortality rate was 17.8%. Stroke has a mortality rate of 25.6%. Olfactory and gustatory dysfunction occurred in 59.9% and 57.5%, respectively.

Conclusions

Stroke is the most frequently reported neurological manifestation in COVID-19 and has the highest mortality rate. Neurological manifestations tend to develop one to two weeks after the onset of respiratory disease. There is significant morbidity and mortality associated with COVID-19 neurological manifestations.

中文翻译：

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COVID-19中的神经系统表现：系统评价和荟萃分析

摘要

目的

在2019年冠状病毒（COVID-19）爆发后，有强有力的证据表明这些患者存在神经系统疾病。我们旨在确定COVID-19中神经系统表现的临床特征。

方法

对报告于2019年12月1日至2020年5月11日发表的神经系统表现的研究进行了系统回顾。根据神经系统表现将研究分组。对个别患者的临床特征以及嗅觉和味觉功能障碍患病率进行汇总分析。

结果

在确定的486个研究中，包括了48个。报道了70例具有73种神经系统表现的患者。39例（53.4％）患有中风，18例（24.7％）患有格林-巴雷综合征和变异，11例（15.1％）患有脑膜炎，脑炎，脑病或脊髓炎，五例（6.8％）患有癫痫发作。他们的平均年龄为61.9±17.7岁（男性为60.6％）。从最初症状出现神经病8.1±6.8天。平均死亡率为17.8％。中风的死亡率为25.6％。嗅觉和味觉功能障碍发生率分别为59.9％和57.5％。

结论

中风是COVID-19中最常报告的神经系统表现，并且死亡率最高。呼吸系统疾病发作后一到两周，神经系统就会发展。与COVID-19神经病学表现有关的发病率和死亡率均很高。