Chua Tzy Harn, Xu Zheyu, King Nicolas Kon Kam
Department of Pathology, Singapore General Hospital , Singapore, Singapore.
Department of Neurology, National Neuroscience Institute , Singapore, Singapore.
Brain Inj. 2020 Oct 14;34(12):1549-1568. doi: 10.1080/02699052.2020.1831606. Epub 2020 Oct 19.
Following the outbreak of coronavirus 2019 (COVID-19), there is strong evidence of neurological involvement in these patients. We aimed to determine the clinical characteristics of neurological manifestations in COVID-19.
A systematic review of studies reporting neurological manifestations published between 1 December, 2019 and 11 May, 2020 was performed. Studies were grouped based on neurological manifestation. Pooled analyses of individual patient's clinical characteristics and olfactory and gustatory dysfunction prevalence were performed.
Of 486 studies identified, 48 were included. 70 patients with 73 neurological manifestations were reported. 39 (53.4%) patients had stroke, 18 (24.7%) had Guillain-Barré syndrome and variants, 11 (15.1%) had meningitis, encephalitis, encephalopathy, or myelitis, and five (6.8%) had seizures. They had a mean age of 61.9 ± 17.7 years (60.6% male). Neurological disease occurred 8.1 ± 6.8 days from initial symptoms. Average mortality rate was 17.8%. Stroke has a mortality rate of 25.6%. Olfactory and gustatory dysfunction occurred in 59.9% and 57.5%, respectively.
Stroke is the most frequently reported neurological manifestation in COVID-19 and has the highest mortality rate. Neurological manifestations tend to develop one to two weeks after the onset of respiratory disease. There is significant morbidity and mortality associated with COVID-19 neurological manifestations.
2019年冠状病毒病（COVID-19）疫情爆发后，有充分证据表明这些患者存在神经受累情况。我们旨在确定COVID-19患者神经表现的临床特征。
对2019年12月1日至2020年5月11日期间发表的报告神经表现的研究进行系统综述。研究根据神经表现进行分组。对个体患者的临床特征以及嗅觉和味觉功能障碍患病率进行汇总分析。
在检索到的486项研究中，纳入了48项。报告了70例患者出现73种神经表现。39例（53.4%）患者发生中风，18例（24.7%）患有吉兰-巴雷综合征及其变异型，11例（15.1%）患有脑膜炎、脑炎、脑病或脊髓炎，5例（6.8%）出现癫痫发作。他们的平均年龄为61.9±17.7岁（男性占60.6%）。神经疾病在出现初始症状后8.1±6.8天发生。平均死亡率为17.8%。中风的死亡率为25.6%。嗅觉和味觉功能障碍的发生率分别为59.9%和57.5%。
中风是COVID-19中最常报告的神经表现，且死亡率最高。神经表现在呼吸道疾病发作后1至2周趋于出现。COVID-19神经表现伴有显著的发病率和死亡率。
