Neurological and psychiatric complications and sequelae of COVID-19: a systematic review

Abstract

The current pandemic caused by the SARS-CoV-2 and its associated disease, COVID-19, has caused a great impact and victimized a considerable portion of the world population. In addition to the high mortality rate, the impact of COVID-19 on the development of complications and sequelae, with repercussions on the patient's functional recovery, hospital discharge, and disability-adjusted life years (DALY), can further aggravate the current scenario. In this context, it is highlighted that SARS-CoV-2 has considerable neurotropism. Therefore, this systematic review addresses the neurological and psychiatric complications and sequelae of COVID-19. A systematic review was conducted using the PubMed/PubMed Central database, following the PRISMA-2020 criteria. After analyses, 56 articles from the aforementioned database were included in this review, plus other relevant publications on the subject, addressing the impacts of direct damage to the nervous system caused by SARS-CoV-2, or indirect, resulting from the response inflammatory and/or immune exacerbated against the virus, in addition to hypercoagulability and hypoxia, which reflect in a wide spectrum of complications and sequelae in COVID-19, whether neurological (including headache, delirium, ischemic and hemorrhagic stroke, changes in smell/taste, and Guillain-Barré syndrome) or psychiatric (including anxiety, post-traumatic stress syndrome, depression, panic attacks, OCD and other cognitive changes). This systematic review also highlights the diagnostic tools, management, therapeutic and rehabilitation strategies. Due to the urgency with which this pandemic arises, the theoretical-practical framework on the subject is still under construction, but already relevant in establishing a link between neurological and psychiatric complications and sequelae and COVID-19, which it may reflect positively on improvements in collective and public health measures aimed at reducing impacts and managing the patient recovered from COVID-19.