Pre-Existing Neurological Conditions and COVID-19 Risk: A Commissioned Rapid Review
17 Pages Posted: 23 Aug 2021
Date Written: June 18, 2021
Abstract
Background: Pre-existing diseases are considered risk factors for severe COVID-19 and death. However, there is lack of consolidated global data on this risk among individuals with pre-existing neurological disease.
Aim: Investigate the impact of pre-existing neurological disease on the clinical course and outcome of COVID-19.
Methods: A rapid review of literature from PubMed and the World Health Organization (WHO) COVID-19 database was conducted for articles published between 1st January 2020 and 4th April 2021. The review included individuals with COVID-19 and pre-existing neurological disease using pre-generated search terms to capture chronic neurological diseases in all age-groups. Articles included in the review were systematic reviews and meta-analysis, cohort studies, retrospective studies, case-control studies and case series. From the included studies, demographic data and Odds Ratios (OR) were extracted, and pooled ORs were generated for the outcomes of COVID-19 severity and death.
Results: Twenty-six articles from 12 countries across three continents with a total of 379,947 COVID-19 patients was included. The mean age was 57 years (SD 10.93), 51.3% of whom were female. Pre-existing neurological disease, particularly cerebrovascular disease and dementia, was shown to be a risk factor for severe COVID-19 with a pooled OR of 1.99 (1.81 – 2.18). There was also an increased risk of death with a pooled OR for pre-existing neurological disease overall of 1.74 (1.56 – 1.94).
Conclusion: The findings suggest that pre-existing neurological disease is a significant risk factor for severe COVID-19 and mortality. Further investigations to consolidate these findings are required through large multi-national cohort studies.
Note: Funding: None.
Declaration of Interests: MC received honorarium for the search and screening of articles for this rapid review from the World Health Organization; honorarium for an article written for Medline not related to this work and grants from the Multiple Sclerosis International Federation (MSIF) and the National Institutes for Health (NIH) not related to this work. CAP declares grants from the NIH for research not related to this work. TS is supported by the National Institute for Health Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections (NIHR200907) at the University of Liverpool (Liverpool, UK). KTT declares funding from NIH for research not related to this work. All other authors have no conflicts of interest to declare that are relevant to the contents of this article.
Keywords: COVID-19, SARS-CoV-2, neurology, comorbidities
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