systematic review and meta-analysis of narcolepsy management during the covid-19 pandemic

The concern has recently been raised for disease status and management of people with narcolepsy after initiation of covid-19 pandemic. here, we evaluated the literature to determine how the covid-19 pandemic has impacted the lives of narcolepsy patients. this was a systematic review and meta-analysis study on online databases of web of science, pubmed, scopus, and sciencedirect using keywords of “narcolepsy”, “sleepiness “, “cataplexy”, “nightmare”, “nocturnal sleep”, “covid-19”, “pandemic”, “sars-cov2”, and “coronavirus”, looking for observational studies. statistical analyses were performed by cam software with significance level being considered at under 0.05 as statistically significant. total number of 9 studies were included with 607 patients with narcolepsy. with a heterogeneity of 99.94%, pooled mean differences (md) of epworth sleepiness scale (ess) scores before and after the pandemic/lockdowns was -1.54 (95%ci: -1.55 to -1.53, p<0.01). the most prevalently increased symptom among the narcolepsy patients was naps taken during the day (58.81%, 95%ci of 50.85 to 66.34) followed by the increased appetite (45.15%, 95%ci of 28.91 to 62.49). our study shows that disease status of narcolepsy patients is affected by covid-19 pandemic. we can assist narcolepsy patients in this challenging position by being aware of their unique demands during the covid-19 illness and sympathetic to their sensitivity.