Exacerbation of neurological symptoms and COVID-19 severity in patients with preexisting neurological disorders and COVID-19: A systematic review

https://doi.org/10.1016/j.clineuro.2020.106349Get rights and content

Highlights

  • COVID-19 effects were studied in patients with comorbid neurological disorder.

  • This review included 26 reports of comorbid neurological disorder and COVID-19.

  • Papers were identified from the MEDLINE (PubMed) and medRxiv databases.

  • Overall, 22.0 % of patients had severe COVID-19 course.

  • Notably, 31.9 % of patients experienced an exacerbation of preexisting neurological symptoms.

Abstract

Background

Patients with chronic diseases likely develop severe 2019 coronavirus disease (COVID-19). However, little is known about the effects of COVID-19 on patients with neurological disorders. We conducted a systematic review to evaluate the severity of COVID-19 and its effect on neurological symptoms in patients with preexisting neurological disorder and COVID-19.

Methods

We searched the MEDLINE (PubMed) and medRxiv databases for reports of patients with both preexisting neurological disorders and COVID-19. Studies reporting data on changes in the symptoms of preexisting neurological disorders and/or the severity of COVID-19 were included.

Results

Twenty-six articles with 2278 patients with preexisting neurological disorder and COVID-19 were identified. Of 232 patients, 74 (31.9 %) showed exacerbation of preexisting neurological symptoms of dementia (55/92; 59.5 %), Parkinson’s disease (10/17; 58.8 %), epilepsy (1/1; 100 %), and unspecified neurological disorders (8/106; 7.5 %). Of 2168 patients, 478 (22.0 %) showed severe COVID-19 course. These included patients with cerebrovascular disease (86/445; 19.3 %), dementia (70/316; 22.2 %), Parkinson’s disease (25/214; 11.7 %), multiple sclerosis (28/71; 39.4 %), spinal cord injury (5/7; 71.4 %), epilepsy (10/98; 10.2 %) and unspecified neurological disorders (254/1011; 25 %).

Conclusions

Patients with preexisting neurological disorders and COVID-19 may develop exacerbation of neurological symptoms and severe COVID-19. Clinicians should be aware of the risk of symptom exacerbation and severe COVID-19 in patients with preexisting neurological disease and should focus on the prevention and early care of COVID-19.

Keywords

COVID-19
Neurological disorder
Neurology
Epilepsy
Systematic
Review

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1

Both authors contributed equally to this manuscript.

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