Neurological and Head/Eyes/Ears/Nose/Throat Manifestations of COVID-19: A Systematic Review and Meta-Analysis

Ganesh, Aravind; Reis, Isabella R.; Varma, Malavika; Patry, David G.; Cooke, Lara

doi:10.1017/cjn.2021.180

Cited by 9 publications

(21 citation statements)

References 150 publications

(182 reference statements)

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“…In our study, patients with both AIS and COVID-19 had significantly higher in-hospital mortality at 16.9%, which was lower than the mortality of 20% to 63.6% documented in the literature yet higher than those with COVID-19 without AIS at 13.1% [ 5 , 9 , 10 ]. When further mortality analysis was performed, which evaluated gender, race, and age, it was found that gender and race have a significant role in mortality outcomes in COVID-19-positive AIS patients, as discussed above.…”

Section: Discussioncontrasting

confidence: 55%

“…Neurological complications have been documented in approximately 36.4% of COVID-19 patients, and roughly 28.2% had severe central nervous system (CNS) injuries, contributing to worse morbidity and mortality [ 4 ]. Known neurological complications include acute ischemic stroke (AIS), neuropsychiatric symptoms, encephalopathy, seizures, myopathies, and polyradiculoneuropathies [ 5 ]. COVID-19 infection is associated with worse outcomes in AIS patients [ 6 , 7 ]; however, large-scale studies evaluating AIS outcomes with COVID-19 infection are limited.…”

Section: Introductionmentioning

confidence: 99%

“…LVOs constitute the greatest proportion (37.3%) of AIS, with the middle cerebral artery as the most common (49.6%) culprit [ 11 ]. Globally, there is a slight difference between sex and incidence of AIS, and this slight predominance in females between countries is due to AIS being more common among older ages and women dominating in senescence [ 5 , 12 ]. Its signs and symptoms are highly variable and include sudden unilateral face and extremity weakness or focal deficits, slurred speech, confusion, vision changes, and death [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…Another mechanism is believed to be due to the binding of the angiotensin-converting enzyme (ACE) 2 receptor and the resultant downregulation of blood pressure [ 4 ]. Additionally, cryptogenic causes are thought to be very common in this population, including endothelial dysfunction and cardiomyopathy after a viral or respiratory illness, resulting in a heightened risk of stroke [ 5 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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COVID-19 and Acute Ischemic Stroke Mortality and Clinical Outcomes among Hospitalized Patients in the United States: Insight from National Inpatient Sample

Davis

Gangu

Suriya

et al. 2023

JCM

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Coronavirus-19, primarily a respiratory virus, also affects the nervous system. Acute ischemic stroke (AIS) is a well-known complication among COVID-19 infections, but large-scale studies evaluating AIS outcomes related to COVID-19 infection remain limited. We used the National Inpatient Sample database to compare acute ischemic stroke patients with and without COVID-19. A total of 329,240 patients were included in the study: acute ischemic stroke with COVID-19 (n = 6665, 2.0%) and acute ischemic stroke without COVID-19 (n = 322,575, 98.0%). The primary outcome was in-hospital mortality. Secondary outcomes included mechanical ventilation, vasopressor use, mechanical thrombectomy, thrombolysis, seizure, acute venous thromboembolism, acute myocardial infarction, cardiac arrest, septic shock, acute kidney injury requiring hemodialysis, length of stay, mean total hospitalization charge, and disposition. Acute ischemic stroke patients who were COVID-19-positive had significantly increased in-hospital mortality compared to acute ischemic stroke patients without COVID-19 (16.9% vs. 4.1%, aOR: 2.5 [95% CI 1.7–3.6], p < 0.001). This cohort also had significantly increased mechanical ventilation use, acute venous thromboembolism, acute myocardial infarction, cardiac arrest, septic shock, acute kidney injury, length of stay, and mean total hospitalization charge. Further research regarding vaccination and therapies will be vital in reducing worse outcomes in patients with acute ischemic stroke and COVID-19.

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Section: Discussioncontrasting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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COVID-19 and Acute Ischemic Stroke Mortality and Clinical Outcomes among Hospitalized Patients in the United States: Insight from National Inpatient Sample

Davis

Gangu

Suriya

et al. 2023

JCM

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“…Seizures 1-4.05% [29,30] Encephalopathy 7-23.5% [29,30] Ischemic stroke 1.3-3% [31][32][33] Hemorrhagic stroke 0.4-0.6% [32,33] Olfactory dysfunction 19-55% [29,30,34] Gustatory dysfunction 21-41% [29,30,34,35] Headache 13-47.1% [29,30,36,37] Fatigue 32-37.8% [29,30,36] Peripheral Neuropathy 1% [30] Cognitive impairment 2% [30] Many COVID-19-associated neurological symptoms persist long after the respiratory process passes. One year after COVID-19 infection, persistent neurological sequelae were reported in 12% of patients; symptoms included fatigue, concentration difficulties, forgetfulness, sleep disturbances, limb weakness, and headache in descending order of prevalence [20].…”

Section: Pooled Prevalencementioning

confidence: 99%

Perspective: COVID-19 and Its Neurologic Sequelae

Rothstein¹,

Christopher²,

Kelly³

et al. 2022

Transl Perioper & Pain Med

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COVID-19 led to a catastrophic, international, public health crisis after its first detection in 2019 [1]. Though it is primarily a respiratory virus, it impacts the central and peripheral nervous systems leading to further COVID-19-associated disability [2]. This Perspective reviews our current understanding of the neurological sequelae of COVID-19 and the gaps in our understanding of their treatment and epidemiology.

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Predictors of Mechanical Ventilation in Guillain–Barré Syndrome with Axonal Subtypes

Michel-Chávez

Chiquete

Gulı́as-Herrero

et al. 2022

Can. J. Neurol. Sci.

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Background: The early clinical predictors of respiratory failure in Latin Americans with Guillain–Barré syndrome (GBS) have scarcely been studied. This is of particular importance since Latin America has a high frequency of axonal GBS variants that may imply a worse prognosis. Methods: We studied 86 Mexican patients with GBS admitted to the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, a referral center of Mexico City, to describe predictors of invasive mechanical ventilation (IMV). Results: The median age was 40 years (interquartile range: 26–53.5), with 60.5% men (male-to-female ratio: 1.53). Most patients (65%) had an infectious antecedent (40.6% gastrointestinal). At admission, 38% of patients had a Medical Research Council (MRC) sum score <30. Axonal subtypes predominated (60.5%), with acute motor axonal neuropathy being the most prevalent (34.9%), followed by acute inflammatory demyelinating polyneuropathy (32.6%), acute motor sensory axonal neuropathy (AMSAN) (25.6%), and Fisher syndrome (7%). Notably, 15.1% had onset in upper limbs, 75.6% dysautonomia, and 73.3% pain. In all, 86% received either IVIg (9.3%) or plasma exchange (74.4%). IMV was required in 39.5% patients (72.7% in AMSAN). A multivariate model without including published prognostic scores yielded the time since onset to admission <15 days, axonal variants, MRC sum score <30, and bulbar weakness as independent predictors of IMV. The model including grading scales yielded lower limbs onset, Erasmus GBS respiratory insufficiency score (EGRIS) >4, and dysautonomia as predictors. Conclusion: These results suggest that EGRIS is a good prognosticator of IMV in GBS patients with a predominance of axonal electrophysiological subtypes, but other early clinical data should also be considered.

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Neurological and Head/Eyes/Ears/Nose/Throat Manifestations of COVID-19: A Systematic Review and Meta-Analysis

Abstract: This version may be subject to change during the production process.

Cited by 9 publications

References 150 publications

COVID-19 and Acute Ischemic Stroke Mortality and Clinical Outcomes among Hospitalized Patients in the United States: Insight from National Inpatient Sample

COVID-19 and Acute Ischemic Stroke Mortality and Clinical Outcomes among Hospitalized Patients in the United States: Insight from National Inpatient Sample

Perspective: COVID-19 and Its Neurologic Sequelae

Predictors of Mechanical Ventilation in Guillain–Barré Syndrome with Axonal Subtypes

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