Objective To study the frequency of neurological symptoms and complications in COVID-19 patients in a systematic review of the literature. Methods Relevant studies were identified through electronic explorations of PubMed, medRxiv, and bioRxiv. Besides, three Chinese databases were searched. A snowballing method searching the bibliographies of the retrieved references was applied to identify potentially relevant articles. Articles published within 1 year prior to April 20th, 2020, were screened with no language restriction imposed. Databases were searched for terms related to SARS-CoV-2/COVID-19 and neurological manifestations, using a pre-established protocol registered on the International Prospective Register of Systematic Reviews database (ID: CRD42020187994). Results A total of 2441 articles were screened for relevant content, of which 92 full-text publications were included in the analyses of neurological manifestations of COVID-19. Headache, dizziness, taste and smell dysfunctions, and impaired consciousness were the most frequently described neurological symptoms, the latter more often among patients with a severe or critical disease course. To date, only smaller cohort studies or single cases have reported cerebrovascular events, seizures, meningoencephalitis, and immune-mediated neurological diseases, not suitable for quantitative analysis. Conclusion The most frequent neurological symptoms reported in association with COVID-19 are non-specific for the infection with SARS-CoV-2. Although SARS-CoV-2 may have the potential to gain direct access to the nervous system, so far, SARS-CoV-2 was detected in the cerebrospinal fluid in two cases only. Standardized international registries are needed to clarify the clinical relevance of the neuropathogenicity of SARS-CoV-2 and to elucidate a possible impact of SARS-CoV-2 infection on common neurological disease, such as Alzheimer’s, Parkinson’s disease or multiple sclerosis. Electronic supplementary material The online version of this article (10.1007/s00415-020-10067-3) contains supplementary material, which is available to authorized users.
【저자키워드】 COVID-19, SARS-CoV-2, nervous system, neuro-COVID, 【초록키워드】 review, protocol, multiple sclerosis, SARS-COV-2 infection, systematic review, database, cohort study, International, Prospective, Patient, Complication, neurological manifestations, Neurological symptoms, cerebrospinal fluid, non-specific, Immune-mediated, Critical disease, association, Frequency, Parkinson’s disease, COVID-19 patient, Seizures, Dizziness, Neurological disease, Quantitative analysis, supplementary material, Chinese, Registered, article, Neurological diseases, neurological manifestation, objective, articles, Neurological symptom, Course, Result, described, identify, reported, events, applied, screened, searched, analysis, infection with SARS-CoV-2, retrieved, with COVID-19, 【제목키워드】 systematic review, complications of COVID-19, Neurological symptom,