Lavienraj Premraj, BMsc (he/him/his)
Griffith University School of Medicine
Brisbane, QLD, Australia
Disclosure information not submitted.
Jack Briggs, BMsc
Mr
Griffith University School of Medicine, Gold Coast, Australia, United States
Disclosure information not submitted.
Stella Seal, MLS
Librarian III
Johns Hopkins School of Medicine, United States
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Denise Battaglini, MD
Dr
Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for oncology and neuroscience, Genoa, Italy, United States
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Jonathon Fanning, MD
Dr
Faculty of Medicine University of Queensland, Brisbane, Qld, Australia, United States
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Chiara Robba, MD, PhD
Professor of anesthesia and critical care, neurocritical care attending
San Martino Policlinico Hospital, United States
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John Fraser, MD
Director, Critical Care research group
University of Queensland, United States
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Sung-Min Cho, DO, MHS
Assistant Professor
Johns Hopkins Hospital, United States
Disclosure information not submitted.
Title: Neurologic and Neuropsychiatric Manifestations of Post-COVID-19 Syndrome: A Meta-Analysis
Introduction: Despite the prevalence of COVID-19 globally, the post-viral syndrome it precipitates remains poorly described. Additionally, the neurotropic nature of SARS-CoV-2 provides further impetus to evaluate the long-term effect of COVID-19 on cognition and behaviour. Thus, in this meta-analysis we report the characteristics of patients who experience neurological or neuropsychiatric symptoms at least 12 weeks after COVID-19 infection. We then determine the pooled prevalence of these symptoms in community, hospital, ICU admitted groups 12- weeks post infection.
Methods: PubMed, EMBASE, Scopus, Google Scholar and Web of Science were searched. All articles with original data published before the 19th of June 2021 that adhered to the NICE definition of post-COVID-19 syndrome with a minimum of 50 patients were included. The random effects model estimate was applied to estimate pooled prevalence in STATA. A total of 808 publications were identified, and 21 studies, with 22,030 patients, met the inclusion criteria.
Results: Of the patients included, 41% were male with average age of 56.5 years. Hypertension was the most frequent comorbidity in both the hospitalised and community groups followed by diabetes. Anosmia, ageusia and headache were key features of acute phase COVID-19 (50.9%, 44.6%, 47.9% respectively). The symptoms of post COVID-19 syndrome were not similarly distributed, post exertional malaise (73.3%), fatigue (43.5%), brain fog (35.1%), memory issues (31.4%), headache (20.2%) and anosmia (11.4%) were most frequent. Generally, the frequency of neurological and neuropsychiatric symptoms in the hospitalised cohort was lower than in the community. In cohorts where 20% or more patients were admitted to the ICU, all neurological and neuropsychiatric symptoms were more prevalent than those in community.There was a notable increase in the prevalence of neurological symptoms after 26 weeks compared to the 12–26-week period.
Conclusions: Our meta-analysis suggests that disease severity, as determined by ICU admission, may be linked to the development of neurological post-COVID-19 syndrome. Neurological symptoms present after COVID-19 infection in a large proportion of patients. Cohort studies that employ risk factor analysis and 12-26 week follow up are required to verify the trends identified.