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Persistent neuropsychiatric symptoms after COVID-19 : a systematic review and meta-analysis
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(2022) Persistent neuropsychiatric symptoms after COVID-19 : a systematic review and meta-analysis. Brain Communications, 4 (1). fcab297. doi:10.1093/braincomms/fcab297 ISSN 2632-1297.
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Official URL: http://dx.doi.org/10.1093/braincomms/fcab297
Abstract
The nature and extent of persistent neuropsychiatric symptoms after COVID-19 are not established. To help inform mental health service planning in the pandemic recovery phase, we systematically determined the prevalence of neuropsychiatric symptoms in survivors of COVID-19. For this pre-registered systematic review and meta-analysis (PROSPERO ID CRD42021239750), we searched MEDLINE, EMBASE, CINAHL and PsycINFO to 20 February 2021, plus our own curated database. We included peer-reviewed studies reporting neuropsychiatric symptoms at post-acute or later time-points after COVID-19 infection and in control groups where available. For each study, a minimum of two authors extracted summary data. For each symptom, we calculated a pooled prevalence using generalized linear mixed models. Heterogeneity was measured with I2. Subgroup analyses were conducted for COVID-19 hospitalization, severity and duration of follow-up. From 2844 unique titles, we included 51 studies (n = 18 917 patients). The mean duration of follow-up after COVID-19 was 77 days (range 14–182 days). Study quality was most commonly moderate. The most prevalent neuropsychiatric symptom was sleep disturbance [pooled prevalence = 27.4% (95% confidence interval 21.4–34.4%)], followed by fatigue [24.4% (17.5–32.9%)], objective cognitive impairment [20.2% (10.3–35.7%)], anxiety [19.1% (13.3–26.8%)] and post-traumatic stress [15.7% (9.9–24.1%)]. Only two studies reported symptoms in control groups, both reporting higher frequencies in COVID-19 survivors versus controls. Between-study heterogeneity was high (I2 = 79.6–98.6%). There was little or no evidence of differential symptom prevalence based on hospitalization status, severity or follow-up duration. Neuropsychiatric symptoms are common and persistent after recovery from COVID-19. The literature on longer-term consequences is still maturing but indicates a particularly high prevalence of insomnia, fatigue, cognitive impairment and anxiety disorders in the first 6 months after infection.
Item Type: | Journal Article | |||||||||||||||||||||
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Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | |||||||||||||||||||||
Library of Congress Subject Headings (LCSH): | COVID-19 (Disease) , COVID-19 (Disease) -- Psychological aspects, COVID-19 (Disease) -- Complications, Neuropsychiatry | |||||||||||||||||||||
Journal or Publication Title: | Brain Communications | |||||||||||||||||||||
Publisher: | Oxford University Press | |||||||||||||||||||||
ISSN: | 2632-1297 | |||||||||||||||||||||
Official Date: | 2022 | |||||||||||||||||||||
Dates: |
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Volume: | 4 | |||||||||||||||||||||
Number: | 1 | |||||||||||||||||||||
Number of Pages: | 15 | |||||||||||||||||||||
Article Number: | fcab297 | |||||||||||||||||||||
DOI: | 10.1093/braincomms/fcab297 | |||||||||||||||||||||
Status: | Peer Reviewed | |||||||||||||||||||||
Publication Status: | Published | |||||||||||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | |||||||||||||||||||||
Date of first compliant deposit: | 14 June 2022 | |||||||||||||||||||||
Date of first compliant Open Access: | 15 June 2022 | |||||||||||||||||||||
RIOXX Funder/Project Grant: |
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