Covid-19 became a global pandemic in 2019. Studies have shown that coronavirus can cause neurological symptoms, but clinical studies on its neurological symptoms are limited. In this meta-analysis, we aimed to summarize the various neurological manifestations that occurred in COVID-19 patients and calculate the incidence of various neurological manifestations. At the same time, we further explored the mechanism of nervous system injury and prognosis in COVID-19 patients in combination with their nervous system manifestations. This study provides a reference for early clinical identification of COVID-19 nervous system injury in the future, so as to achieve early treatment and reduce neurological sequelae. We systematically searched all published English literature related to the neurological manifestations of COVID-19 from January 1, 2020, to April 30, 2021, in Pubmed, Embase, and Cochrane Library. The keywords used were COVID-19 and terminology related to the nervous system performance. All included studies were selected by two independent reviewers using EndNote and NoteExpress software, any disagreement was resolved by consensus or by a third reviewer, and the selected data were then collected for meta-analysis using a random-effects model. A total of 168 articles (n = 292,693) were included in the study, and the meta-analysis showed that the most common neurological manifestations of COVID-19 were myalgia(33%; 95%CI 0.30–0.37; I2 = 99.17%), smell impairment(33%; 95%CI 0.28–0.38; I2 = 99.40%), taste dysfunction(33%; 95%CI 0.27–0.39; I2 = 99.09%), altered mental status(32%; 95%CI 0.22–0.43; I2 = 99.06%), headache(29%; 95%CI 0.25–0.33; I2 = 99.42%), encephalopathy(26%; 95%CI 0.16–0.38; I2 = 99.31%), alteration of consciousness(13%; 95%CI 0.08–0.19; I2 = 98.10%), stroke(12%; 95%CI 0.08–0.16; I2 = 98.95%), dizziness(10%; 95%CI 0.08–0.13; I2 = 96.45%), vision impairment(6%; 95%CI 0.03–0.09; I2 = 86.82%), intracerebral haemorrhage(5%; 95%CI 0.03–0.09; I2 = 95.60%), seizure(4%; 95%CI 0.02 -0.05; I2 = 98.15%), encephalitis(2%; 95%CI 0.01–0.03; I2 = 90.36%), Guillan-Barré Syndrome (GBS) (1%; 95%CI 0.00–0.03; I2 = 89.48%). Neurological symptoms are common and varied in Covid-19 infections, and a growing number of reports suggest that the prevalence of neurological symptoms may be increasing. In the future, the role of COVID-19 neurological symptoms in the progression of COVID-19 should be further studied, and its pathogenesis and assessment methods should be explored, to detect and treat early neurological complications of COVID-19 and reduce mortality.

中文翻译：

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COVID-19 的神经学表现可以告诉我们什么：荟萃分析

Covid-19在2019年成为全球大流行病。研究表明，冠状病毒可引起神经系统症状，但对其神经系统症状的临床研究有限。在这项荟萃分析中，我们旨在总结 COVID-19 患者发生的各种神经系统表现，并计算各种神经系统表现的发生率。同时，我们结合他们的神经系统表现，进一步探讨了COVID-19患者神经系统损伤的机制和预后。本研究为今后临床早期识别COVID-19神经系统损伤提供参考，从而实现早期治疗，减少神经系统后遗症。我们系统地检索了自 2020 年 1 月 1 日起所有已发表的与 COVID-19 神经系统表现相关的英文文献，至 2021 年 4 月 30 日，在 Pubmed、Embase 和 Cochrane 图书馆。使用的关键字是 COVID-19 和与神经系统性能相关的术语。所有纳入的研究均由两名独立审查员使用 EndNote 和 NoteExpress 软件选择，任何分歧通过共识或第三名审查员解决，然后收集所选数据以使用随机效应模型进行荟萃分析。该研究共纳入 168 篇文章（n = 292,693），荟萃分析显示 COVID-19 最常见的神经系统表现是肌痛（33%；95%CI 0.30–0.37；I2 = 99.17%） ，嗅觉障碍（33%；95%CI 0.28–0.38；I2 = 99.40%），味觉障碍（33%；95%CI 0.27–0.39；I2 = 99.09%），精神状态改变（32%；95%CI 0.22） –0.43；I2 = 99.06%），头痛（29%；95%CI 0.25–0.33；I2 = 99.42%），脑病（26%；95%CI 0。16–0.38；I2 = 99.31%），意识改变（13%；95%CI 0.08–0.19；I2 = 98.10%），中风（12%；95%CI 0.08–0.16；I2 = 98.95%），头晕（10%；95） %CI 0.08–0.13；I2 = 96.45%），视力障碍（6%；95%CI 0.03–0.09；I2 = 86.82%），脑出血（5%；95%CI 0.03–0.09；I2 = 95）。癫痫发作（4%；95%CI 0.02 -0.05；I2 = 98.15%），脑炎（2%；95%CI 0.01–0.03；I2 = 90.36%），吉兰-巴雷综合征（GBS）（1%；95%CI） 0.00–0.03；I2 = 89.48%）。神经系统症状在 Covid-19 感染中很常见且多种多样，越来越多的报告表明神经系统症状的患病率可能正在增加。未来应进一步研究COVID-19神经症状在COVID-19进展中的作用，探索其发病机制和评估方法，