University College of Medical Sciences (University of Delhi), Dilshad Garden, Delhi,India.
CNS Neurol Disord Drug Targets. 2022;21(3):246-258. doi: 10.2174/1871527320666210216121211.
The current ongoing COVID-19 pandemic has compelled us to scrutinize major outbreaks in the past two decades, Severe Acute Respiratory Syndrome (SARS), in 2002, and Middle East Respiratory Syndrome (MERS), in 2012. We aimed to assess the associated neurological manifestations with SARS CoV-2 infection.
In this systematic review, a search was carried out by key-electronic databases, controlled vocabulary, and indexing of trials to evaluate the available pertinent studies which included both medical subject headings (MeSH) and advanced electronic databases comprising PubMed, Embase, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL). Peer-reviewed studies published in English and Spanish were considered, which reported data on the neurological associations of individuals with suspected or laboratory-confirmed SARS-CoV-2 infection. Outcomes were nervous signs or symptoms, symptom severity, and diagnoses.
Our search identified 45 relevant studies, with 21 case reports, 3 case series, 9 observational studies, 1 retrospective study, 9 retrospective reviews, and 2 prospective reviews. This systematic review revealed that most commonly reported neuronal presentations involved headache, nausea, vomiting and muscular symptoms like fibromyalgia. Anosmia and ageusia, defects in clarity or sharpness of vision (error in visual acuity), and pain may occur in parallel. Notable afflictions in the form of anxiety, anger, confusion, post-traumatic stress symptoms, and post-intensive care syndrome were observed in individuals who were kept in quarantine and those with long-stay admissions in healthcare settings. SARS CoV-2 infection may result in cognitive impairment. Patients with more severe infection exhibited uncommon manifestations, such as acute cerebrovascular diseases (intracerebral haemorrhage, stroke), rhabdomyolysis, encephalopathy, and Guillain-Barré syndrome.
SARS-CoV-2 patients experience neuronal presentations varying with the progression of the infection. Healthcare professionals should be acquainted with the divergent neurological symptoms to curb misdiagnosis and limit long-term sequelae. Health-care planners and policymakers must prepare for this eventuality, while the ongoing studies increase our knowledge base on acute and chronic neurological associations of this pathogen.
当前正在进行的 COVID-19 大流行迫使我们仔细研究过去二十年中的两次重大疫情，即 2002 年的严重急性呼吸综合征（SARS）和 2012 年的中东呼吸综合征（MERS）。我们旨在评估 SARS-CoV-2 感染相关的神经系统表现。
在这项系统评价中，通过关键电子数据库、临床试验的受控词汇和索引进行了检索，以评估包括医学主题词（MeSH）和高级电子数据库（包括 PubMed、Embase、Scopus、Cochrane 中央对照试验注册中心（CENTRAL））在内的现有相关研究。纳入了以英文和西班牙语发表的报告疑似或实验室确诊 SARS-CoV-2 感染个体的神经系统关联的研究。结果为神经体征或症状、症状严重程度和诊断。
我们的检索共确定了 45 项相关研究，其中包括 21 项病例报告、3 项病例系列、9 项观察性研究、1 项回顾性研究、9 项回顾性综述和 2 项前瞻性综述。这项系统评价显示，最常报告的神经元表现涉及头痛、恶心、呕吐和肌肉症状，如纤维肌痛。嗅觉和味觉丧失、视力清晰度或锐利度缺陷（视力误差）以及疼痛可能同时发生。在被隔离的个体和在医疗保健环境中长期住院的个体中观察到焦虑、愤怒、困惑、创伤后应激症状和重症监护后综合征等显著疾病。SARS-CoV-2 感染可能导致认知障碍。感染更严重的患者表现出不常见的表现，如急性脑血管疾病（脑出血、中风）、横纹肌溶解症、脑病和格林-巴利综合征。
SARS-CoV-2 患者的神经元表现随感染的进展而变化。医疗保健专业人员应熟悉不同的神经系统症状，以避免误诊并限制长期后遗症。卫生保健规划者和政策制定者必须为此做好准备，同时正在进行的研究增加了我们对这种病原体的急性和慢性神经关联的知识库。
