Neuropsychological and brain atrophy pattern characterization in patients with stroke related to COVID infection: A systematic review

Introduction: The high mortality rates in patients with COVID infection have been the main focus of interest in clinical and research practice. COVID infection has also been characterized by its respiratory consequences; however, several studies have reported neurological manifestations in this clinical population (e.g., stroke). From a neurological perspective, patients with stroke related to COVID infection remain challenging as well. No systematic reviews have yet focused on neuropsychological and neuroanatomical correlate profiles. Aim: To characterize the neuropsychological profile and the pattern of brain areas affected in adult and older adults with stroke related to COVID infection. Methods: The present study followed the PRISMA guidelines and included studies from the PubMed, Scopus, and Web of Sciences databases, published between January 2020 and September 2022. Results: 7 articles were included in this systematic review for critical analysis. Ischemic stroke was the most reported in patients. Results suggest that the most reported neuropsychological declines are orientation, attention, memory, executive function, visuoconstructive skills, and language. The pattern of brain areas also considers right lesions in cortical and subcortical regions. Conclusion: In patients with COVID-related strokes, lesions in the left hemisphere or bilateral are common, together with the expression of aphasia. Likewise, our findings reflect only ischemic patients' cognitive and brain features. Therefore, results must be interpreted carefully.