Persistent Neuropsychiatric Symptoms After COVID-19

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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 PubMed, EMBASE, CINAHL and PsycINFO to 20th 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 primary pooled prevalence using generalised linear mixed models.

Heterogeneity was measured with I2.

Subgroup analyses were conducted for COVID-19 hospitalisation, severity, and duration of follow-up.

From 2,844 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 generally moderate.

The most frequent neuropsychiatric symptom was sleep disturbance, followed by fatigue, objective cognitive impairment, anxiety, and post-traumatic stress.

Only two studies reported symptoms in control groups, both reporting higher frequencies in Covid-19 survivors versus controls.

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