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Cited by 119Long-Term Effects of COVID-19Infectious Encephalopathies and EncephalitisCOVID-19 Clinical Research Studies

Neurological involvement of coronavirus disease 2019: a systematic review

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Ghannam, Malik, Alshaer, Qasem, Al-Chalabi, Mustafa, Zakarna, Lara, Robertson, Jetter, Manousakis, Georgios·2020·Journal of Neurology
DOI 10.1007/s00415-020-09990-2PMC PMC7304377
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Abstract

Background In December 2019, unexplained cases of pneumonia emerged in Wuhan, China, which were found to be secondary to the novel coronavirus SARS-CoV-2. On March 11, 2020, the WHO declared the Coronavirus Disease 2019 (COVID-2019) outbreak, a pandemic. Objective To clarify the neurological complications of SARS-CoV-2 infection including the potential mechanisms and therapeutic options. Methods We conducted a systematic literature search from December 01, 2019 to May 14, 2020 using multiple combinations of keywords from PubMed and Ovid Medline databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included articles with cases of COVID-19 where neurological involvement was evident. Results We were able to identify 82 cases of COVID-19 with neurological complications. The mean age was 62.3 years. 37.8% of the patients were women (n = 31). 48.8% of the patients (n = 40) had cerebrovascular insults, 28% (n = 23) had neuromuscular disorders, and 23% of the patients (n = 19) had encephalitis or encephalopathy. Conclusions Neurological manifestations of COVID-19 are not rare, especially large vessel stroke, Guillain-Barre syndrome, and meningoencephalitis. Moving forward, further studies are needed to clarify the prevalence of the neurological complications of SARS-CoV-2 infection, investigate their biological backgrounds, and test treatment options. Physicians should be cautious not to overlook other neurological diagnoses that can mimic COVID-19 during the pandemic.

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  • Viral infections such as Zika and SARS-CoV-2 have been associated with neurologic syndromes that include dysautonomia and GI complaints in some patients.

    “Viral infections such as Zika and SARS-CoV-2 have also been associated with neurologic syndromes that include dysautonomia and GI complaints in some patients (Counotte et al., 2019; Ghannam et al., 2020).”

    From Autonomic nervous system and gastrointestinal manifestations with an emphasis on gastric dysfunction (2026) · cites this paper as Ghannam et al., 2020

    The Results (page not available) report neurological syndromes in patients with COVID-19 and say that GI symptoms preceded the syndrome in two patients. The review does not identify dysautonomia among those syndromes, and it describes GI symptoms as preceding—not forming part of—the neurological syndrome. The Zika portion has a separate citation and is not judged against this source. (LLM, conf=0.85)

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References 105 · Cited by 119

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Authors
Ghannam, M., Alshaer, Q., Al-Chalabi, M., Zakarna, L., Robertson, J., & Manousakis, G.
Affiliations
  • University of Minnesota (US)
  • Emory University (US)
  • University of Toledo (US)
  • An-Najah National University (PS)
Corresponding author
  • Ghannam, Malik
  • Manousakis, Georgios
ORCID
Venue
Journal of Neurology
Publisher
Springer Science and Business Media LLC
Published
2020-06-19
Volume
267
Issue
11
Pages
3135-3153
ISSN
  • 0012-1037 (ISSN-L)
  • 0340-5354
  • 1432-1459
DOI
10.1007/s00415-020-09990-2
PMC
PMC7304377
OpenAlex
W3035936306
Cited by
119
References
105
Citations by year
2026: 3 · 2025: 2 · 2024: 6 · 2023: 11 · 2022: 22 · 2021: 49 · 2020: 26
FWCI
3.03
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Neurology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Keywords
COVID-19 pandemic, SARS-CoV-2, neurological complications, cerebrovascular disease, stroke, Guillain-Barré syndrome, neuromuscular disorders, encephalitis, meningoencephalitis, encephalopathy, pathophysiological mechanisms, treatment options
MeSH terms
Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Aged, Female, Humans, Male, Middle Aged, Nervous System Diseases, Pneumonia, Viral, Prevalence, Coronavirus Infections, Pandemics

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