1. Meta-analysis/systematic review
In this nice paper recently published in the European Journal of Neurology, the authors systematically reviewed available evidence for reports of neurological signs and symptoms in COVID‐19 patients to identify cases with SARS‐CoV‐2 infection or immune‐mediated reaction in the nervous system.
The authors analysed 27 publications on potentially neuroinvasive or parainfectious neurological complications of COVID‐19. The reports focused on loss of smell and taste (n=5) and evaluation of neurological symptoms and signs in cohorts (n=5). There were cases of Guillain‐Barré syndrome/Miller‐Fisher syndrome/cranial neuropathy (7 cases), meningitis/encephalitis (9 cases) and various other conditions (5 cases). Few patients underwent CSF examination and, in particular, SARS‐CoV‐2 CSF PCR. Amongst these cases, two had a positive SARS‐CoV‐2 PCR in the CSF. The study of potential parenchymal involvement with magnetic resonance imaging was rare. Only 4 reports received a rating for the highest quality standards. The authors concluded that their systematic review failed to establish comprehensive insights into nervous system manifestations of COVID‐19 beyond immune‐mediated complications as an aftermath of respiratory symptoms. Therefore, they provide guidance for more careful clinical, diagnostic and epidemiological studies to characterize the manifestations and burden of neurological disease caused by SARS‐CoV‐2 on behalf of the Infectious Disease Panel of the European Academy of Neurology.