Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, USA.
Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti Univsersity of Medical Sciences, Tehran, Iran.
J Neurol Sci. 2020 Jun 15;413:116832. doi: 10.1016/j.jns.2020.116832. Epub 2020 Apr 11.
In this systematic review, we will discuss the evidence on the occurrence of central nervous system (CNS) involvement and neurological manifestations in patients with COVID-19.
MEDLINE (accessed from PubMed) and Scopus from December 01, 2019 to March 26, 2020 were systematically searched for related published articles. In both electronic databases, the following search strategy was implemented and these key words (in the title/abstract) were used: "COVID 19" OR "coronavirus" AND "brain" OR "CNS" OR "neurologic".
Through the search strategy, we could identify two articles about neurological involvement by COVID-19. One of these publications was a narrative review and the other one was a viewpoint. However, the authors scanned the reference lists of the included studies and could identify multiple references. One study, specifically investigated the neurological manifestations of COVID-19 and could document CNS manifestations in 25% of the patients. Most of the studies investigated the manifestations of COVID-19 in general.
While neurological manifestations of COVID-19 have not been studied appropriately, it is highly likely that some of these patients, particularly those who suffer from a severe illness, have CNS involvement and neurological manifestations. Precise and targeted documentation of neurological symptoms, detailed clinical, neurological, and electrophysiological investigations of the patients, attempts to isolate SARS-CoV-2 from cerebrospinal fluid, and autopsies of the COVID-19 victims may clarify the role played by this virus in causing neurological manifestations.
在本系统评价中,我们将讨论 COVID-19 患者中枢神经系统(CNS)受累和神经表现的证据。
系统检索了 2019 年 12 月 1 日至 2020 年 3 月 26 日 MEDLINE(从 PubMed 检索)和 Scopus 中与已发表文章相关的内容。在这两个电子数据库中,实施了以下搜索策略,并使用了以下关键词(在标题/摘要中):“COVID-19”或“冠状病毒”和“脑”或“CNS”或“神经病学”。
通过搜索策略,我们可以确定两篇关于 COVID-19 神经受累的文章。其中一篇是叙述性综述,另一篇是观点文章。然而,作者扫描了纳入研究的参考文献列表,并可以识别出多个参考文献。其中一项研究专门研究了 COVID-19 的神经表现,并能记录到 25%的患者有 CNS 表现。大多数研究都调查了 COVID-19 的一般表现。
虽然 COVID-19 的神经表现尚未得到适当研究,但很可能某些患者,特别是那些患有严重疾病的患者,存在 CNS 受累和神经表现。准确和有针对性地记录神经症状,对患者进行详细的临床、神经和电生理检查,尝试从脑脊液中分离 SARS-CoV-2,以及对 COVID-19 受害者进行尸检,可能会阐明该病毒在引起神经表现方面的作用。