Evidence map›Paper›PMID 40514644›Full record

SynthesisBMC neurology2025

Long-term neurological and cognitive impact of COVID-19: a systematic review and meta-analysis in over 4 million patients.

Toka Elboraay, Mahmoud A Ebada, Maged Elsayed, Heba Ahmed Aboeldahab, Hazem Mohamed Salamah, Omar Rageh, Mohamed Elmallahy, Hadeer Elsaeed AboElfarh, Lena Said Mansour, Yehia Nabil and 3 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Review
  5. Article
  6. Review
  7. Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Toka Elboraay *Faculty of Medicine, Zagazig University, Zagazig, El-Sharkia, Egypt.
Mahmoud A Ebada *Faculty of Medicine, Zagazig University, Zagazig, El-Sharkia, Egypt. Mahmoud_Ebada@outlook.com.ORCID http://orcid.org/0000-0001-5284-2929
Maged ElsayedFaculty of Medicine, Zagazig University, Zagazig, El-Sharkia, Egypt.
Heba Ahmed AboeldahabClinical Research Department, El-Gomhoria General Hospital, MOHP, Karmouz, Alexandria, Egypt.
Hazem Mohamed SalamahFaculty of Medicine, Zagazig University, Zagazig, El-Sharkia, Egypt.
Omar RagehFaculty of Medicine, Tanta University, Tanta, Egypt.
Mohamed ElmallahyFaculty of Medicine, Tanta University, Tanta, Egypt.
Hadeer Elsaeed AboElfarhNeurology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Lena Said MansourFaculty of Medicine and Internal Medicine Resident, Damanhour Teaching Hospital, Damanhour, Beheira, Egypt.
Yehia NabilFaculty of Medicine, Zagazig University, Zagazig, El-Sharkia, Egypt.
Ahmed Khaled Abd EltawabSednawy Health Insurance Hospital, Cairo, Egypt.
Hany AtwanFaculty of Medicine, Assiut University, Assiut, Egypt.
Souad AlkanjFaculty of Medicine, Zagazig University, Zagazig, El-Sharkia, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeuropsychiatric symptoms emerged early in the COVID-19 pandemic as a key feature of the virus, with research confirming a range of neuropsychiatric manifestations linked to acute SARS-CoV-2 infection. However, the persistence of neurological symptoms in the post-acute and chronic phases remains unclear. This meta-analysis assesses the long-term neurological effects of COVID-19 in recovered patients, providing insights for mental health service planning.

methodsA comprehensive literature search was conducted across five electronic databases: PubMed, Scopus, Web of Science, EBSCO, and CENTRAL, up to March 22, 2024. Studies evaluating the prevalence of long-term neurological symptoms in COVID-19 survivors with at least six months of follow-up were included. Pooled prevalence estimates, subgroup analyses, and meta-regression were performed, and publication bias was assessed.

resultsThe prevalence rates for the different symptoms were as follows: fatigue 43.3% (95% CI [36.1-50.9%]), memory disorders 27.8% (95% CI [20.1-37.1%]), cognitive impairment 27.1% (95% CI [20.4-34.9%]), sleep disorders 24.4% (95% CI [18.1-32.1%]), concentration impairment 23.8% (95% CI [17.2-31.9%]), headache 20.3% (95% CI [15-26.9%]), dizziness 16% (95% CI [9.5-25.7%]), stress 15.9% (95% CI [10.2-24%]), depression 14.0% (95% CI [10.1-19.2%]), anxiety 13.2% (95% CI [9.6-17.9%]), and migraine 13% (95% CI [2.2-49.8%]). Significant heterogeneity was observed across all symptoms. Meta-regression analysis showed higher stress, fatigue, and headache in females, and increased stress and concentration impairment with higher BMI.

conclusionsNeurological symptoms are common and persistent in COVID-19 survivors. This meta-analysis highlights the significant burden these symptoms place on individuals, emphasizing the need for well-resourced multidisciplinary healthcare services to support post-COVID recovery. REGISTRATION AND PROTOCOL: This meta-analysis was registered in PROSPERO with registration number CRD42024576237.

Indexed as

Cognitive DysfunctionCOVID-19Nervous System DiseasesFatigueHumansPrevalenceCOVID-19 recoveryLong COVIDMultidisciplinary careNeurological manifestationsPost-COVID syndrome

Identifiers

PMID40514644
PMCPMC12166599

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.