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Central Nervous System Complications in COVID-19 Patients; a Systematic Review and Meta-Analysis based on Current Evidence.
Arch Acad Emerg Med. 2020; 8(1):e62.AA

Abstract

Introduction

Several studies have confirmed neurological involvements, such as acute cerebrovascular disease and impaired consciousness in COVID-19. In the present study, our aim is to investigate the current evidence regarding central nervous system (CNS) complications in patients with confirmed COVID-19.

Methods

An extensive search was conducted in electronic databases including Medline (using PubMed), Embase, Scopus, and Web of Science, in addition to the manual search in Google and Google scholar search engines, for articles published from 2019 until April 21st, 2020. Inclusion criteria was articles that were reviewed and reported the incidence of neurological outcomes in patients with confirmed COVID-19 disease.

Results

The initial search yielded 638 records, from which 7 articles were included. Overall, the incidence of CNS complications was calculated to be 6.27% (95% CI: 3.32 to 9.98). The incidence of the most common CNS complications, encephalopathy and acute cerebrovascular disease, were 9.14% (95%CI: 2.20 to 19.81) and 2.59% (95% CI: 1.31 to 4.25), respectively.

Conclusion

CNS complications do exist in COVID-19 patients, encephalopathy being the most concerning one. The heterogeneity in the existing literature causes an uncertainty in reporting the definite prevalence rate for each complication. Thus, further studies are needed for scientists to reach a more accurate estimate of the prevalence of these complications in COVID-19 patients. However, healthcare providers should consider the possibility of CNS involvements in patients with SARS-CoV-2 infection.

Authors+Show Affiliations

Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran.Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran.College of Medicine, University of Sulaimani, Sulaimani, Iraq.Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran.Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran.Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33134959

Citation

MadaniNeishaboori, Arian, et al. "Central Nervous System Complications in COVID-19 Patients; a Systematic Review and Meta-Analysis Based On Current Evidence." Archives of Academic Emergency Medicine, vol. 8, no. 1, 2020, pp. e62.
MadaniNeishaboori A, Moshrefiaraghi D, Mohamed Ali K, et al. Central Nervous System Complications in COVID-19 Patients; a Systematic Review and Meta-Analysis based on Current Evidence. Arch Acad Emerg Med. 2020;8(1):e62.
MadaniNeishaboori, A., Moshrefiaraghi, D., Mohamed Ali, K., Toloui, A., Yousefifard, M., & Hosseini, M. (2020). Central Nervous System Complications in COVID-19 Patients; a Systematic Review and Meta-Analysis based on Current Evidence. Archives of Academic Emergency Medicine, 8(1), e62.
MadaniNeishaboori A, et al. Central Nervous System Complications in COVID-19 Patients; a Systematic Review and Meta-Analysis Based On Current Evidence. Arch Acad Emerg Med. 2020;8(1):e62. PubMed PMID: 33134959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Central Nervous System Complications in COVID-19 Patients; a Systematic Review and Meta-Analysis based on Current Evidence. AU - MadaniNeishaboori,Arian, AU - Moshrefiaraghi,Donya, AU - Mohamed Ali,Kosar, AU - Toloui,Amirmohammad, AU - Yousefifard,Mahmoud, AU - Hosseini,Mostafa, Y1 - 2020/06/07/ PY - 2020/11/2/entrez PY - 2020/11/3/pubmed PY - 2020/11/3/medline KW - COVID-19 KW - Central Nervous System Diseases KW - Prevalence KW - Stroke SP - e62 EP - e62 JF - Archives of academic emergency medicine JO - Arch Acad Emerg Med VL - 8 IS - 1 N2 - Introduction: Several studies have confirmed neurological involvements, such as acute cerebrovascular disease and impaired consciousness in COVID-19. In the present study, our aim is to investigate the current evidence regarding central nervous system (CNS) complications in patients with confirmed COVID-19. Methods: An extensive search was conducted in electronic databases including Medline (using PubMed), Embase, Scopus, and Web of Science, in addition to the manual search in Google and Google scholar search engines, for articles published from 2019 until April 21st, 2020. Inclusion criteria was articles that were reviewed and reported the incidence of neurological outcomes in patients with confirmed COVID-19 disease. Results: The initial search yielded 638 records, from which 7 articles were included. Overall, the incidence of CNS complications was calculated to be 6.27% (95% CI: 3.32 to 9.98). The incidence of the most common CNS complications, encephalopathy and acute cerebrovascular disease, were 9.14% (95%CI: 2.20 to 19.81) and 2.59% (95% CI: 1.31 to 4.25), respectively. Conclusion: CNS complications do exist in COVID-19 patients, encephalopathy being the most concerning one. The heterogeneity in the existing literature causes an uncertainty in reporting the definite prevalence rate for each complication. Thus, further studies are needed for scientists to reach a more accurate estimate of the prevalence of these complications in COVID-19 patients. However, healthcare providers should consider the possibility of CNS involvements in patients with SARS-CoV-2 infection. SN - 2645-4904 UR - https://www.unboundmedicine.com/medline/citation/33134959/Central_Nervous_System_Complications_in_COVID_19_Patients L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/33134959/ DB - PRIME DP - Unbound Medicine ER -