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Publications

Systematic Review Epublish 8 citations

PubMed: 35493827 DOI: 10.3389/fneur.2022.814405

Non-Invasive Multimodal Neuromonitoring in Non-Critically Ill Hospitalized Adult Patients With COVID-19: A Systematic Review and Meta-Analysis.

Front Neurol 13:814405

Authors: Denise Battaglini, Lavienraj Premraj, Samuel Huth, Jonathon Fanning, Glenn Whitman, Rakesh C Arora, Judith Bellapart, Diego Bastos Porto, Fabio Silvio Taccone, Jacky Y Suen, Gianluigi Li Bassi, John F Fraser, Rafael Badenes, Sung-Min Cho, Chiara Robba

Affiliations

  • Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy.
  • Department of Medicine, University of Barcelona, Barcelona, Spain.
  • Griffith University School of Medicine, Gold Coast, QLD, Australia.
  • Critical Care Research Group (CCRG), Herston, QLD, Australia.
  • Faculty of Medicine, The University of Queensland, Herston, QLD, Australia.
  • St. Andrew's War Memorial Hospital, Uniting Care Health, Spring Hill, QLD, Australia.
  • School of Medicine, Johns Hopkins University, Baltimore, MD, United States.
  • Department of Surgery, Section of Cardiac Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
  • Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
  • Department of Critical Care, Sao Camilo Cura D'ars Hospital, Fortaleza, Brazil.
  • Intensive Care Unit, Erasmus Hospital, Free University of Brussels, Brussels, Belgium.
  • Queensland University of Technology, Herston, QLD, Australia.
  • Institut de Ricerca Biomedica August Pi i Sunyer (IDIBAPS), Valencia, Spain.
  • Department of Anesthesia and Intensive Care, Hospital Clinic Universitari, INCLIVA Research Health Institute, University of Valencia, Valencia, Spain.
  • Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.

Abstract

Introduction

Neurological complications are frequent in patients with coronavirus disease-2019 (COVID-19). The use of non-invasive neuromonitoring in subjects without primary brain injury but with potential neurological derangement is gaining attention outside the intensive care unit (ICU). This systematic review and meta-analysis investigates the use of non-invasive multimodal neuromonitoring of the brain in non-critically ill patients with COVID-19 outside the ICU and quantifies the prevalence of abnormal neuromonitoring findings in this population.

Methods

A structured literature search was performed in MEDLINE/PubMed, Scopus, Cochrane, and EMBASE to investigate the use of non-invasive neuromonitoring tools, including transcranial doppler (TCD); optic nerve sheath diameter (ONSD); near-infrared spectroscopy (NIRS); pupillometry; and electroencephalography (EEG) inpatients with COVID-19 outside the ICU. The proportion of non-ICU patients with CVOID-19 and a particular neurological feature at neuromonitoring at the study time was defined as prevalence.

Results

A total of 6,593 records were identified through literature searching. Twenty-one studies were finally selected, comprising 368 non-ICU patients, of whom 97 were considered for the prevalence of meta-analysis. The pooled prevalence of electroencephalographic seizures, periodic and rhythmic patterns, slow background abnormalities, and abnormal background on EEG was.17 (95% CI 0.04-0.29), 0.42 (95% CI 0.01-0.82), 0.92 (95% CI 0.83-1.01), and.95 (95% CI 0.088-1.09), respectively. No studies investigating NIRS and ONSD outside the ICU were found. The pooled prevalence for abnormal neuromonitoring findings detected using the TCD and pupillometry were incomputable due to insufficient data.

Conclusions

Neuromonitoring tools are non-invasive, less expensive, safe, and bedside available tools with a great potential for both diagnosis and monitoring of patients with COVID-19 at risk of brain derangements. However, extensive literature searching reveals that they are rarely used outside critical care settings. www.crd.york.ac.uk/prospero/display_record.php?RecordID=265617, identifier: CRD42021265617.

MeSH

Brain, Covid-19, Critical Illness, Prevalence, Intensive Care Units

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