A prospective clinical study of detailed neurological manifestations in patients with COVID-19

Karadaş, Ömer; Öztürk, Bilgin; Sonkaya, Ali Rıza

doi:10.1007/s10072-020-04547-7

Cited by 161 publications

(222 citation statements)

References 17 publications

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“…There was variation in stroke incidence rates among individuals with COVID-19 across the included studies. This may reflect differences in the population studied; highest rates were reported in cohorts of critically ill patients (18,19), and in studies analyzing neurological complications of COVID-19 (20)(21)(22). It may also reflect differences in healthcare system organization, and intensity of neurologic screening.…”

Section: Stroke Features In Covid-19 Patients Compared With Non-covidmentioning

confidence: 99%

Stroke in COVID-19: A systematic review and meta-analysis

Nannoni

Groot

Bell

et al. 2020

International Journal of Stroke

478

496

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Background: Coronavirus disease 2019 (COVID-19) has become a global pandemic, affecting millions of people. However, the relationship between COVID-19 and acute cerebrovascular diseases (CVD) is unclear. Aims: We aimed to characterize the incidence, risk factors, clinical-radiological manifestations and outcome of COVID-19-associated stroke. Methods: Three medical databases were systematically reviewed for published articles on acute CVD in COVID-19 (December 2019-September 2020). The review protocol was previously registered (PROSPERO ID=CRD42020185476). Data were extracted from articles reporting ï³5 stroke cases in COVID-19. We complied with the PRISMA guidelines, and used the NewcastleâOttawa Scale to assess data quality. Data were pooled using a random-effects model. Summary of review: Of 2,277 initially identified articles, 61 (2.7%) were entered in the meta-analysis. Out of 108,571 patients with COVID-19, acute CVD occurred in 1.4% (95%CI: 1.0-1.9). The most common manifestation was acute ischemic stroke (87.4%); intracerebral haemorrhage was less common (11.6%). Patients with COVID-19 developing acute CVD, compared to those who did not, were older (pooled median difference=4.8 years; 95%CI:1.7-22.4), more likely to have hypertension (OR=7.35; 95%CI:1.94-27.87), diabetes mellitus (OR=5.56; 95%CI:3.34-9.24), coronary artery disease (OR=3.12; 95%CI:1.61-6.02), and severe infection (OR=5.10; 95%CI:2.72-9.54). Compared to individuals who experienced a stroke without the infection, patients with COVID-19 and stroke were younger (pooled median difference=-6.0 years; 95%CI:-12.3 to -1.4), had higher NIHSS (pooled median difference=5; 95%CI:3-9), higher frequency of large vessel occlusion (OR=2.73; 95%CI:1.63-4.57), and higher in-hospital mortality rate (OR=5.21; 95% CI:3.43-7.90). Conclusions: Acute CVD is not uncommon in COVID-19, especially in those whom are severely infected and have pre-existing vascular risk factors. The pattern of large vessel occlusion and multi-territory infarcts suggest that cerebral thrombosis and/or thromboembolism could be possible causative pathways for the disease.

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Section: Stroke Features In Covid-19 Patients Compared With Non-covidmentioning

confidence: 99%

Stroke in COVID-19: A systematic review and meta-analysis

Nannoni

Groot

Bell

et al. 2020

International Journal of Stroke

478

496

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“…We included 31 studies 43,44,[70][71][72][73][74][75] with 5153 patients in our analysis, including two preprint articles 43,93 (see Fig. 1).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Twenty-seven (87%) studies 43,44,[70][71][72][73][85][86][87][88][89][90][91][92][93][94][96][97][98][99][100][101][102][103][104][105]107 were conducted in China, and the remaining four studies were, respectively, conducted in Italy, 75 Ecuador, 95 Turkey, 74 and Iran. 106 Twenty-eight (90%) studies were cross-sectional studies, 43,44,[70][71][72][73][74][75][85][86][87][88]90,[92][93][94][95][96][97][98]…”

Section: Study Characteristicsmentioning

confidence: 99%

The prevalence of depression, anxiety, and sleep disturbances in COVID‐19 patients: a meta‐analysis

Deng

Zhou

Hou

et al. 2020

Annals of the New York Academy of Sciences

633

499

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Evidence from previous coronavirus outbreaks has shown that infected patients are at risk for developing psychiatric and mental health disorders, such as depression, anxiety, and sleep disturbances. To construct a comprehensive picture of the mental health status in COVID-19 patients, we conducted a systematic review and randomeffects meta-analysis to assess the prevalence of depression, anxiety, and sleep disturbances in this population. We searched MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, Wanfang Data, Wangfang Med Online, CNKI, and CQVIP for relevant articles, and we included 31 studies (n = 5153) in our analyses. We found that the pooled prevalence of depression was 45% (95% CI: 37-54%, I 2 = 96%), the pooled prevalence of anxiety was 47% (95% CI: 37-57%, I 2 = 97%), and the pooled prevalence of sleeping disturbances was 34% (95% CI: 19-50%, I 2 = 98%). We did not find any significant differences in the prevalence estimates between different genders; however, the depression and anxiety prevalence estimates varied based on different screening tools. More observational studies assessing the mental wellness of COVID-19 outpatients and COVID-19 patients from countries other than China are needed to further examine the psychological implications of COVID-19 infections.

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“…By now it is well-known that neurological manifestations occur in ∼35% of COVID-19 patients, and potentially in a majority of patients with more severe infections. 1 - 3 Results of electroencephalogram (EEG) in these patients are of particular interest: (1) How frequently is epileptiform activity seen in this patient population, and are the underlying risks for epileptiform activity different from other critically ill patients? (2) Are there novel EEG features specific to COVID-19?…”

Section: Commentarymentioning

confidence: 99%