Neurological manifestations of patients infected with the SARS-CoV-2: a systematic review of the literature
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REVIEW
Neurological manifestations of patients infected with the SARS‑CoV‑2: a systematic review of the literature Federico Cagnazzo1 · Caroline Arquizan2 · Imad Derraz1 · Cyril Dargazanli1 · Pierre‑Henri Lefevre1 · Carlos Riquelme1 · Nicolas Gaillard2 · Isabelle Mourand2 · Gregory Gascou1 · Alain Bonafe1 · Vincent Costalat1 Received: 18 May 2020 / Revised: 14 October 2020 / Accepted: 20 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective To perform an updated review of the literature on the neurological manifestations of COVID-19-infected patients Methods A PRISMA-guideline-based systematic review was conducted on PubMed, EMBASE, and SCOPUS. Series reporting neurological manifestations of COVID-19 patients were studied. Results 39 studies and 68,361 laboratory-confirmed COVID-19 patients were included. Up to 21.3% of COVID-19 patients presented neurological symptoms. Headache (5.4%), skeletal muscle injury (5.1%), psychiatric disorders (4.6%), impaired consciousness (2.8%), gustatory/olfactory dysfunction (2.3%), acute cerebrovascular events (1.4%), and dizziness (1.3%), were the most frequently reported neurological manifestations. Ischemic stroke occurred among 1.3% of COVID-19 patients. Other less common neurological manifestations were cranial nerve impairment (0.6%), nerve root and plexus disorders (0.4%), epilepsy (0.7%), and hemorrhagic stroke (0.15%). Impaired consciousness and acute cerebrovascular events were reported in 14% and 4% of patients with a severe disease, respectively, and they were significantly higher compared to non-severe patients (p 0.05 at the Shapiro–Wilk test. For normal variables, mean and standard deviation (SD) were reported; for variable without a normal distribution, median and interquartile range (IQR) were used. The frequency of neurological and non-neurological symptoms was compared using the chi-square test. Differences between sub-groups of analysis were considered significant at p
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