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Pre-existing neurological conditions and COVID-19 co-infection: Data from systematic reviews, meta-analyses, and scoping reviews

Boruah AP 1 , Thakur KT 2 , Gadani SP 3 , Kothari KU 4 , Chomba M 5 , Guekht A 6 Show all authors , Heydari K 7 , Hoo FK 8 , Hwang S 9 , Michael BD 10 , Pandit MV 11 , Pardo CA 3 , Prasad K 12 , Sardar Z 13 , Seeher K 14 , Solomon T 15 , Winkler AS 16 , Wood GK 17 , Schiess N 18

Affiliations 

  • 1 Case Western Reserve University School of Medicine, OH, USA
  • 2 Department of Neurology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, USA
  • 3 Johns Hopkins Department of Neurology, Baltimore, USA
  • 4 Consultant to Library & Digital Information Networks, World Health Organization, Geneva, Switzerland
  • 5 University of Zambia, Lusaka, Zambia
  • 6 Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia; Pirogov Russian Medical Research University, Moscow, Russia
  • 7 Columbia University, New York, USA
  • 8 Faculty of Medicine and Health Sciences, University Putra Malaysia, Kuala Lumpur, Malaysia
  • 9 Icahn School of Medicine at Mount Sinai, New York, USA
  • 10 Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Department of Neurology, Walton Centre NHS Foundation Trust, NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK
  • 11 New York Medical College, Valhalla, USA
  • 12 Department of Neurology Fortis Flt Lt, Rajan Dhall Hospital, Vasant Kunj, New Delhi, India
  • 13 Columbia University Irving Medical Center, New York, NY, USA
  • 14 Brain Health Unit, World Health Organization, Geneva, Switzerland
  • 15 The Pandemic Institute, The Spine, Liverpool L7 3FA, UK; National Institute for Health and Care Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool L69 7BE, UK; Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool L69 7BE, UK; Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, UK
  • 16 Department of Neurology, Center for Global Health, Technical University of Munich, Munich, Germany; Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
  • 17 Department of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, UK
  • 18 Brain Health Unit, World Health Organization, Geneva, Switzerland. Electronic address: schiessn@who.int
J Neurol Sci, 2023 Dec 15;455:120858.
PMID: 37948972 DOI: 10.1016/j.jns.2023.120858

Abstract

BACKGROUND: Pre-existing neurological diseases have been identified as risk factors for severe COVID-19 infection and death. There is a lack of comprehensive literature review assessing the relationship between pre-existing neurological conditions and COVID-19 outcomes. Identification of high risk groups is critical for optimal treatment and care.

METHODS: A literature review was conducted for systematic reviews, meta-analyses, and scoping reviews published between January 1, 2020 and January 1, 2023. Literature assessing individuals with pre-existing neurological diseases and COVID-19 infection was included. Information regarding infection severity was extracted, and potential limitations were identified.

RESULTS: Thirty-nine articles met inclusion criteria, with data assessing >3 million patients from 51 countries. 26/51 (50.9%) of countries analyzed were classified as high income, while the remaining represented middle-low income countries (25/51; 49.0%). A majority of evidence focused on the impact of cerebrovascular disease (17/39; 43.5%) and dementia (5/39; 12.8%) on COVID-19 severity and mortality. 92.3% of the articles (36/39) suggested a significant association between neurological conditions and increased risk of severe COVID-19 and mortality. Cerebrovascular disease, dementia, Parkinson's disease, and epilepsy were associated with increased COVID severity and mortality.

CONCLUSION: Pre-existing neurological diseases including cerebrovascular disease, Alzheimer's disease and other dementias, epilepsy, and Parkinson's disease are significant risk factors for severity of COVID-19 infection and mortality in the acute infectious period. Given that 61.5% (24/39) of the current evidence only includes data from 2020, further updated literature is crucial to identify the relationship between chronic neurological conditions and clinical characteristics of COVID-19 variants.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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