Neurological, neuropsychiatric and psychiatric symptoms during COVID-19 infection and after recovery: a systematic review of observational studies

M. Stavrou, S. Solomou, A. Kythreotou, A. Ioannou, Eva Lioutas, Joanna Lioutas, P. Karayiannis
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Abstract

Background The SARS-CoV-2 virus causes a wide spectrum of disease severity. Initial manifestations include fever, dry cough, and constitutional symptoms, which may progress to respiratory disease. There may also be neurological and psychiatric manifestations, involving both the central and peripheral nervous system. Methods We performed a literature search of the databases PubMed, EMBASE, The Cochrane Library and Web of Science for observational studies reporting neurological, psychiatric, and neuropsychiatric effects of COVID-19. This was followed by a narrative synthesis to summarise the data and discuss neuropsychiatric associations, symptom severity, management, and recovery. Findings The most frequently reported neurological symptoms were ageusia, hyposmia/anosmia, dizziness, headache, and loss of consciousness. Statistically significant relationships were noted between Asian ethnicity and peripheral neuropathy (p=0.0001) and neuro-syndromic symptoms (p=0.001). ITU admission was found to have a statistically significant relationship with male sex (p=0.024). Depression and anxiety were also identified both during and after infection. The most frequent treatments used were intravenous immunoglobulins, followed by antibiotics, antivirals, and hydroxychloroquine; with mean treatment duration of 6 days. Interpretation Various neuropsychiatric symptoms have been associated with COVID-19 infection. More studies are required to further our knowledge in the management of neurological and psychiatric symptoms during and after COVID-19 infection
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新冠肺炎感染期间和康复后的神经、神经精神和精神症状:观察性研究的系统综述
背景:SARS-CoV-2病毒可引起多种严重程度的疾病。最初表现为发热、干咳和体质症状,可发展为呼吸道疾病。也可能有神经和精神方面的表现,包括中枢和周围神经系统。方法:我们在PubMed、EMBASE、Cochrane图书馆和Web of Science数据库中进行文献检索,以获取报道COVID-19神经、精神和神经精神影响的观察性研究。随后进行叙述性综合,总结数据并讨论神经精神病学关联、症状严重程度、管理和恢复。发现最常见的神经系统症状为听觉障碍、嗅觉减退、头晕、头痛和意识丧失。亚裔与周围神经病变(p=0.0001)和神经综合征症状(p=0.001)之间存在统计学上显著的关系。国际电联录取与男性性别有统计学显著关系(p=0.024)。在感染期间和感染后也发现了抑郁和焦虑。最常用的治疗方法是静脉注射免疫球蛋白,其次是抗生素、抗病毒药物和羟氯喹;平均治疗时间6天。各种神经精神症状与COVID-19感染相关。需要更多的研究来进一步了解COVID-19感染期间和之后的神经和精神症状的管理
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