Abstract
There is accumulating evidence of the neurological and neuropsychiatric
features of infection with SARS-CoV-2. In this systematic review and
meta-analysis, we aimed to describe the characteristics of the early
literature and estimate point prevalences for neurological and
neuropsychiatric manifestations.
We searched MEDLINE, Embase, PsycINFO and CINAHL up to 18 July 2020 for
randomised controlled trials, cohort studies, case-control studies,
cross-sectional studies and case series. Studies reporting prevalences of
neurological or neuropsychiatric symptoms were synthesised into
meta-analyses to estimate pooled prevalence.
13 292 records were screened by at least two authors to identify 215
included studies, of which there were 37 cohort studies, 15 case-control
studies, 80 cross-sectional studies and 83 case series from 30 countries.
147 studies were included in the meta-analysis. The symptoms with the
highest prevalence were anosmia (43.1% (95% CI 35.2% to 51.3%), n=15 975, 63
studies), weakness (40.0% (95% CI 27.9% to 53.5%), n=221, 3 studies),
fatigue (37.8% (95% CI 31.6% to 44.4%), n=21 101, 67 studies), dysgeusia
(37.2% (95% CI 29.8% to 45.3%), n=13 686, 52 studies), myalgia (25.1% (95%
CI 19.8% to 31.3%), n=66 268, 76 studies), depression (23.0% (95% CI 11.8%
to 40.2%), n=43 128, 10 studies), headache (20.7% (95% CI 16.1% to 26.1%),
n=64 613, 84 studies), anxiety (15.9% (5.6% to 37.7%), n=42 566, 9 studies)
and altered mental status (8.2% (95% CI 4.4% to 14.8%), n=49 326, 19
studies). Heterogeneity for most clinical manifestations was high.
Neurological and neuropsychiatric symptoms of COVID-19 in the pandemic’s
early phase are varied and common. The neurological and psychiatric academic
communities should develop systems to facilitate high-quality methodologies,
including more rapid examination of the longitudinal course of
neuropsychiatric complications of newly emerging diseases and their
relationship to neuroimaging and inflammatory biomarkers.
Funder
Association of British Neurologists
Japan
Agency for Medical Research and
Development
Oxford
Health Biomedical Research Centre
UK
Research and Innovation
Deutsche
Forschungsgemeinschaft
Medical
Research Council
Research
Trainees Coordinating Centre
Royal
College of Physicians of Edinburgh
National
Institute for Health Research
Wellcome
Trust
Faculty
of Medicine, Chulalongkorn University,
Thailand
Subject
Psychiatry and Mental health,Neurology (clinical),Surgery