Persistent neuropsychiatric symptoms after COVID-19: a systematic review and meta-analysis.
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Authors
Rengasamy, Emma R
Watson, Cameron
Jansen, Katrin
Chakraborty, Stuti
Sundaram, Ritika D
Saini, Aman
Thomas, Lucretia
Cross, Benjamin
Hunt, Camille K
Conti, Isabella
Ralovska, Sylvia
Hussain, Zain
Butler, Matthew
Koychev, Ivan
Michael, Benedict D
Holling, Heinz
Nicholson, Timothy R
Rooney, Alasdair G
Publication Date
2022Journal Title
Brain Commun
ISSN
2632-1297
Publisher
Oxford University Press (OUP)
Volume
4
Issue
1
Language
eng
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Badenoch, J. B., Rengasamy, E. R., Watson, C., Jansen, K., Chakraborty, S., Sundaram, R. D., Hafeez, D., et al. (2022). Persistent neuropsychiatric symptoms after COVID-19: a systematic review and meta-analysis.. Brain Commun, 4 (1) https://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 I 2. 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 (I 2 = 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.
Keywords
Neuropsychiatry, Covid-19, Long Covid, Chronic Covid Syndrome, Post-Acute Sequelae Of Covid-19
Sponsorship
Medical Research Foundation (C0396)
Wellcome Trust (102186/B/13/Z)
Medical Research Council (MR/J000914/1)
Identifiers
35169700, PMC8833580
External DOI: https://doi.org/10.1093/braincomms/fcab297
This record's URL: https://www.repository.cam.ac.uk/handle/1810/335231
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