h-index: 7     i10-index: 5

Document Type : Review Article

Authors

1 Shirvan Center of Higher Health education, Imam Khomeini Hospital, North Khorasan University of Medical Sciences, Bojnurd, Iran

2 Medical Genetics Research Center, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran

3 MD, PhD, Assistant Professor of Medical Informatics, Medical Informatics Research Center, Institute for Futures Studies in Heaith, Kerman University of Medical Sciences, Kerman, Iran

4 Researcher at the Anesthesia and Pain, Molecular and cell Biology Research center, Faculty of Medicine Department of Anatomy, Iran University of Medical Sciences, Tehran, Iran

Abstract

all evidence suggests the existence of neurological involvement in COVID-19, the existence of comprehensive studies such as systematic and meta-analysis can be a good guide for scientists. Hence the aim of present systematic review and meta‐analysis study was assessed the complication of central nervous system in COVID‐19 patients. From the electronic databases, PubMed, Cochrane Library, Embase, ISI have been used to perform a systematic literature until February 2021. Prevalence with 95% confidence interval, fixed effect model, Inverse-variance method were calculated. Random effects were used to deal with potential heterogeneity and I2 showed heterogeneity. The Meta analysis have been evaluated with the statistical software Stata/MP v.16. According to the purpose of the study, in the initial search with keywords, 501 articles were found, the full text of 75 studies was reviewed. Finally, six studies were selected. Prevalence of Acute Cerebrovascular disease, Encephalopathy, Other Neurological manifestations such as: Cerebral ischemic stroke, Brain perfusion abnormalities, Dysexecutive syndrome and Ataxia was 2.67% (ES, 2.67% 95% CI 1.71%, 3.64%), 10.28% (ES, 10.28% 95% CI 8.19%, 12.37%) and 16.70% (ES, 16.79% 95% CI 15.45%, 17.94%), respectively. Overall prevalence of CNS complication in patients with COVID‐19 was 9.61 % (ES, 9.61% 95% CI 8.04%, 11.19%). The results of the Present systematic review and meta-analysis showed that Acute Cerebrovascular disease and Encephalopathy have a higher prevalence among patients with COVID-19. These results can help physicians better diagnose CNS signs and symptoms. Attention should be paid to all CNS complications in COVID-19 patients.

Graphical Abstract

Assessed the Complication of Central Nervous System in COVID‐19 Patients: A Systematic Review and Meta‐Analysis

Keywords

Main Subjects

[1]  S.P. Adhikari, S. Meng, Y.J. Wu, Y.P. Mao, R.X. Ye, Q.Z. Wang, C. Sun, S. Sylvia, S. Rozelle, H. Raat, H. Zhou, Infectious diseases of poverty, 2020, 9, 1-12. [crossref], [Google Scholar], [Publisher]
[2]  X. Yang, Y. Yu, J. Xu, H. Shu, H. Liu, Y. Wu, L. Zhang, Z. Yu, M. Fang, T. Yu, Y. Wang, The Lancet Respiratory Medicine, 2020, 8, 475-481. [crossref], [Google Scholar], [Publisher]
[3]  W. Zhao, Z. Zhong, X. Xie, Q. Yu, J. Liu, Theranostics, 2020, 10, 4606-4613. [crossref], [Google Scholar], [Publisher]
[4]  F. Liu, Q. Zhang, C. Huang, C. Shi, L. Wang, N. Shi, C. Fang, F. Shan, X. Mei, J. Shi, F. Song, Theranostics, 2020, 10, 5613-5622. [crossref], [Google Scholar], [Publisher]
[5]  P.P. Xu, R.H. Tian, S. Luo, Z.Y. Zu, B. Fan, X.M. Wang, K. Xu, J.T. Wang, J. Zhu, J.C. Shi, F. Chen, Theranostics, 2020, 10, 6372-6383. [crossref], [Google Scholar], [Publisher]
[6]  V. Montalvan, J. Lee, T. Bueso, J. De Toledo, K. Rivas, Clinical Neurology and Neurosurgery, 2020, 194, 105921. [crossref], [Google Scholar], [Publisher]
[7]  M. Ghannam, Q. Alshaer, M. Al-Chalabi, L. Zakarna, J. Robertson, G. Manousakis, Journal of neurology, 2020, 1-19. [crossref], [Google Scholar], [Publisher]
[8]  L. Pellegrini, A. Albecka, D.L. Mallery, M.J. Kellner, D. Paul, A.P. Carter, L.C. James, M.A. Lancaster, Cell Stem cell, 2020, 27, 951-961. e5. [crossref], [Google Scholar], [Publisher]
[9]  C.O.C. Co, J.R.T. Yu, L.C. Laxamana, D.I.A. David-Ona, Journal of Clinical Neuroscience, 2020, 77, 234-236. [crossref], [Google Scholar], [Publisher]
[10]       P.S. Espinosa, Z. Rizvi, P. Sharma, F. Hindi, A. Filatov, Cureus, 2020, 12. [crossref], [Google Scholar], [Publisher]
[11]       A. Filatov, P. Sharma, F. Hindi, P.S. Espinosa, Cureus, 2020, 12. [crossref], [Google Scholar], [Publisher]
[12]       L. Mao, H. Jin, M. Wang, Y. Hu, S. Chen, Q. He, J. Chang, C. Hong, Y. Zhou, D. Wang, X. Miao, Y. Li, B. Hu, JAMA neurology, 2020, 77, 683-690. [crossref], [Google Scholar], [Publisher]
[13]       A.M. Baig, A. Khaleeq, U. Ali, H. Syeda, ACS chemical neuroscience, 2020, 11, 995-998. [crossref], [Google Scholar], [Publisher]
[14]       X. He, J. Lai, J. Cheng, M. Wang, Y. Liu, Z. Xiao, C. Xu, S.S. Li, H.S. Zeng, Zhonghua Xin Xue Guan Bing Za Zhi, 2020, 48, 456-460. [crossref], [Google Scholar], [Publisher]
[15]       B.W. McCrindle, J.S. Li, C. Manlhiot, J.S. Tweddell, T.M. Giglia, M.P. Massicotte, P. Monagle, R. Krishnamurthy, K.W. Mahaffey, A.D. Michelson, N. Verdun, C.S. Almond, J.W. Newburger, L.R. Brandão, C.T. Esmon, M.J. Manco-Johnson, R. Ichord, T.L. Ortel, A.K. Chan, R. Portman, M. Rose, J. Strony, J.R. Kaltman. Circulation, 2014, 130, 1192-203. [crossref], [Google Scholar], [Publisher]
[16]       J. Helms, S. Kremer, H. Merdji, R. Clere-Jehl, M. Schenck, C. Kummerlen, O. Collange, C. Boulay, S. Fafi-Kremer, M. Ohana, M. Anheim, F. Meziani, New England Journal of Medicine, 2020, 382, 2268-70. [crossref], [Google Scholar], [Publisher]
[17]       F.A. Klok, M.J.H.A. Kruip, N.J.M. Van der Meer, M.S. Arbous, D.A.M.P.J. Gommers, K.M. Kant, F.H.J. Kaptein, J. van Paassen, M.A.M. Stals, M.V. Huisman, H. Endeman, Thrombosis research, 2020, 191, 145-7. [crossref], [Google Scholar], [Publisher]
[18]       Y. Li, M. Li, M. Wang, Y. Zhou, J. Chang, Y. Xian, D. Wang, L. Mao, H. Jin, B. Hu, Stroke and vascular neurology, 2020, 5, 279-284. [crossref], [Google Scholar], [Publisher]
[19]       C. Lodigiani, G. Iapichino, L. Carenzo, M. Cecconi, P. Ferrazzi, T. Sebastian, N. Kucher, J.D. Studt, C. Sacco, A. Bertuzzi, M.T. Sandri, S. Barco, Thrombosis research, 2020, 191, 9-14. [crossref], [Google Scholar], [Publisher]
[20]       Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, K. Ma, D. Xu, H. Yu, H. Wang, T. Wang, W. Guo, J. Chen, C. Ding, X. Zhang, J. Huang, M. Han, S. Li, X. Luo, J. Zhao, Q. Ning, BMJ (Clinical researched), 2020, 368. [crossref], [Google Scholar], [Publisher]
[21]       F. Zare Kazemabadi, A. Heydarinasab, A. Akbarzadehkhiyavi, M. Ardjmand, Chemical Methodologies, 2021, 5, 135-152. [crossref], [Google Scholar], [Publisher]
[22]       M. Bagheri sadr, A. Bozorgian, International Journal of Advanced Studies in Humanities and Social Science, 2020, 9, 252-261. [crossref], [Google Scholar], [Publisher]
[23]       H. Jahandideh, A. Yarahmadi, S. Rajaieh, A. Ostvar Shirazi, M.M. Fard, A. Yarahmadi, Journal of Pharmaceutical Research International, 2019, 1-7. [crossref], [Google Scholar], [Publisher]
[24]       S. Nazari, A. Azari Jafari, S. Mirmoeeni, S. Sadeghian, M.E. Heidari, S. Sadeghian, F. Assarzadegan, S.M. Puormand, H. Ebadi, D. Fathi, S. Dalvand, Brain and behavior, 2020, e02025. [crossref], [Google Scholar], [Publisher]
[25]       C. Kaur, E. Ling, Blood brain barrier in hypoxic-ischemic conditions. Current neurovascular research, 2008, 5, 71-81. [crossref], [Google Scholar], [Publisher]
[26]       A. Achar, C. Ghosh, Cells, 2020, 9, 2360. [crossref], [Google Scholar], [Publisher]
[27]       T. Moriguchi, N. Harii, J. Goto, D. Harada, H. Sugawara, J. Takamino, M. Ueno, H. Sakata, K. Kondo, N. Myose, A. Nakao, M. Takeda, H. Haro, O. Inoue, K. Suzuki-Inoue, K. Kubokawa, S. Ogihara, T. Sasaki, H. Kinouchi, H. Kojin, M. Ito, H. Onishi, T. Shimizu, Y. Sasaki, N. Enomoto, H. Ishihara, S. Furuya, T. Yamamoto, S. Shimada, International Journal of Infectious Diseases, 2020, 94, 55-8. [crossref], [Google Scholar], [Publisher]
[28]       I.J. Borges do Nascimento, N. Cacic, H.M. Abdulazeem, T.C. von Groote, U. Jayarajah, I. Weerasekara, M.A. Esfahani, V.T. Civile, A. Marusic, A. Jeroncic, N.C. Junior, T.P. Pericic, I. Zakarija-Grkovic, S.M.M. Guimarães, Nicola L. Bragazzi, M. Bjorklund, A. Sofi-Mahmudi, M. Altujjar, M. Tian, D.M.C. Arcani, D.P. O'Mathúna, M.S. Marcolino, Journal of clinical medicine, 2020, 9, 941. [crossref], [Google Scholar], [Publisher]
[29]       J.Y. Choi, H.K. Lee, J.H. Park, S.J. Cho, M. Kwon, C. Jo, Y.H. Koh, Biochemical and biophysical research communications, 2020, 528, 413-419. [crossref], [Google Scholar], [Publisher]
[30]       R Alimoradzadeh, M Mokhtare, S Agah, Iranian Journal of Ageing, 2017, 12, 78-89. [crossref], [Google Scholar], [Publisher]
[31]       R. Alimoradzadeh, M.A. Abbasi, F. Zabihi, H. Mirmiranpour, Iranian Journal of Ageing, 2021, 15, 524-533. [crossref], [Google Scholar], [Publisher]
[32]       S Etemadi, B Mahmoodiyeh, S Rajabi, A Kamali, M Milanifard, Annals of the Romanian Society for Cell Biology, 2021, 25, 2417-2426. [crossref], [Google Scholar], [Publisher]
[33]       S. Zarinabadi, A. Esfandiyari, S.A. Khoddami, A. Samimi, Journal of Fundamental and Applied Sciences, 2016, 8, 1133-1149. [crossref], [Google Scholar], [Publisher]
[34]       S. Zarinabadi, A. Samimi, Journal of Fundamental and Applied Sciences, 2016, 8, 1160-1172. [crossref], [Google Scholar], [Publisher]
[35]       M. Bagheri Sadr, A. Bozorgian, Journal of Chemical Reviews, 2021, 3, 66-82. [crossref], [Google Scholar], [Publisher]
[36]       M. Bagheri Sadr, A. Bozorgian, Journal of Chemical Reviews, 2021, 3, 66-82. [crossref], [Google Scholar], [Publisher]
[37] A. Bozorgian, Journal of Chemical Reviews, 2021, 3, 50-65. [crossref], [Google Scholar], [Publisher]
[38]       A. Amini, H. Shahpoori Arani, M. Milani Fard, Eurasian Journal of Science and Technology, 2021, 1, 421-424. [crossref], [Google Scholar], [Publisher]
[39]       A.M.M. Fard, M.M. Fard, Eurasian Journal of Science and Technology, 2021, 1, 384-398. [crossref], [Google Scholar], [Publisher]
[40]       A. Samimi, International Science and Investigation journal, 2014, 3, 57-64. [crossref], [Google Scholar], [Publisher]
[41]       A. Samimi, Journal of Engineering in Industrial Research, 2021, 2, 71-76. [crossref], [Google Scholar], [Publisher]
[42]       A. Susanabadi, M.S. Sadri, H. Taleby, S. Etemadi, B. Mahmoodiyeh, M.M. Fard, Annals of the Roma-nian Society for Cell Biology, 2021, 25, 2703-2716. [Google Scholar], [Publisher]
[43]       A. Susanabadi, S. Etemadi, M.S. Sadri, B. Mahmoodiyeh, H. Taleby, M.M. Fard, Annals of the Romanian Society for Cell Biology, 2021, 25, 2875–2887. [Google Scholar], [Publisher]
[44]       A. Yarahmadi, K. Kamrava, A. Shafee, M.M. Fard, M. Aghajanpour, A. Mohebbi, Journal of Pharmaceutical Research International, 2020, 31, 1-6. [crossref], [Google Scholar], [Publisher]
[45]       A. Bozorgian, S. Zarinabadi, A. Samimi, Journal of Chemical Reviews, 2020, 2, 122-129. [crossref], [Google Scholar], [Publisher]
[46]       A.M.M. Fard, M.M. Fard, Journal of Science and Technology Research, 2021, 1, 284-301. [crossref], [Google Scholar], [Publisher]
[47]       A.M.M. Fard, M.M. Fard, Eurasian Journal of Science and Technology, 2021, 1, 384-398. [crossref], [Google Scholar], [Publisher]
[48]       A.M.M. Fard, M.M. Fard, Eurasian Journal of Science and Technology, 2021, 1, 284-301. [crossref], [Google Scholar], [Publisher]
[49]       A.O. Shirazi, H. Jahandideh, A. Yarahmadi, M.M. Fard, M.M. Delarestaghi, Medical Science, 2020, 24, 2467-2474 [crossref], [Google Scholar], [Publisher]
[50]       B. Mahmoodiyeh, S. Etemadi, A. Kamali, S. Rajabi, M.M. Fard, Annals of the Romanian Society for Cell Biology, 2021, 25, 2559–2572. [Google Scholar], [Publisher]
[51]       Barmasi, Journal of Engineering in Industrial Research, 2020, 1, 161-169. [crossref], [Google Scholar], [Publisher]
[52]       A. Bozorgian, Journal of Engineering in Industrial Research, 2020, 1, 1-18. [crossref], [Google Scholar], [Publisher]
[53]       E.S. Motaharian, B. Mahmoodiyeh, S. Lorestani, M.S. Sadri, M.M. Fard, A.M.M. Fard, A. Amini, Journal of Chemical Reviews, 2021, 3, 171-180. [crossref], [Google Scholar], [Publisher]
[54]       E.A. Mahdiraji, M. Sedghi Amiri, Journal of Engineering in Industrial Research, 2020, 1, 111-122. [crossref], [Google Scholar], [Publisher]
[55]       A. Bozorgian, A. Samimi, International Journal of New Chemistry, 2021, 8, 41-58. [crossref], [Google Scholar], [Publisher]
[56]       F. Zabihi, M.A. Abbasi, R. Alimoradzadeh, Annals of the Romanian Society for Cell Biology, 2021, 25, 2573–2579. [Google Scholar], [Publisher]
[57]       F. Gharekhani Kasa, Journal of Engineering in Industrial Research, 2020, 1, 51-74. [crossref], [Google Scholar], [Publisher]
[58]       F. Rebout, Journal of Engineering in Industrial Research, 2020, 1, 19-37. [crossref], [Google Scholar], [Publisher]
[59]       F. Zare Kazemabadi, A. Heydarinasab, A. Akbarzadeh, M. Ardjmand, Artificial cells, nanomedicine, and biotechnology, 2019, 47, 3222-3230. [crossref], [Google Scholar], [Publisher]
[60] S.V. Mousavi, A. Bozorgian, N. Mokhtari, M.A. Gabris, H.R. Nodeh, Microchemical Journal, 2019, 145, 914-920. [crossref], [Google Scholar], [Publisher]
[61] A. Bozorgian, Advanced Journal of Chemistry, Section B: Natural Products and Medical Chemistry, 2021, 3, 54-61. [crossref], [Google Scholar], [Publisher]
[62]       S.M.S. Mirnezami, F. Zare Kazemabadi, A. Heydarinasab, Progress in Chemical and Biochemical Research, 2021, 4, 191-206. [crossref], [Google Scholar], [Publisher]
[63]       A. Bozorgian, Chemical Review and Letters, 2020, 3, 79-85. [crossref], [Google Scholar], [Publisher]
[64]       M.M. Fard, A. Amini, M. Shafie Aghol, Eurasian Journal of Science and Technology, 2021, 1, 399-411. [crossref], [Google Scholar], [Publisher]
[65]       M.M. Fard, A.M.M. Fard, Eurasian Journal of Science and Technology, 2021, 1, 365-383. [crossref], [Google Scholar], [Publisher]
[66]       M.M. Fard, A.M.M. Fard, Eurasian Journal of Science and Technology, 2021, 1, 271-283. [crossref], [Google Scholar], [Publisher]
[67]       M. Mokhtare, R. Alimoradzadeh, S. Agah, H. Mirmiranpour, N. Khodabandehloo,, Middle East journal of digestive diseases, 2017, 9, 228. [crossref], [Google Scholar], [Publisher]
[68]       R. Alimoradzadeh, H. Mirmiranpour, P. Hashemi, S. Pezeshki, S.S. Salehi, Journal of Neurology & Neurophysiology, 2019, 10, 1-5. [crossref], [Google Scholar], [Publisher]
[69]       M. Zbuzant, Journal of Engineering in Industrial Research, 2020, 1, 75-81. [crossref], [Google Scholar], [Publisher]
[70]       M.M. Fard, A.M.M. Fard, Journal of Science and Technology Research, 2021, 1, 365-383. [crossref], [Google Scholar], [Publisher]
[71]       A. Haghighi Asl, A. Ahmadpour, N. Fallah, Applied Chemistry, 2017, 12, 253-286. [crossref], [Google Scholar], [Publisher]