EAN consensus statement for management of patients with neurological diseases during the COVID‐19 pandemic

Abstract

Background and purpose The recent SARS‐CoV‐2 pandemic has posed multiple challenges to the practice of clinical neurology including recognition of emerging neurological complications and management of coexistent neurological diseases. In a fast‐evolving pandemic, evidence‐based studies are lacking in many areas. This paper presents European Academy of Neurology (EAN) expert consensus statements to guide neurologists caring for patients with COVID‐19. Methods A refined Delphi methodology was applied. In round 1, statements were provided by EAN scientific panels (SPs). In round 2, these statements were circulated to SP members not involved in writing them, asking for agreement/disagreement. Items with agreement >70% were retained for round 3, in which SP co‐chairs rated importance on a five‐point Likert scale. Results were graded by importance and reported as consensus statements. Results In round one, 70 statements were provided by 23 SPs. In round two, 259/1061 SP member responses were received. Fifty‐nine statements obtained >70% agreement and were retained. In round three, responses were received from 55 co‐chairs of 29 SPs. Whilst general recommendations related to prevention of COVID‐19 transmission had high levels of agreement and importance, opinion was more varied concerning statements related to therapy. Conclusion This is the first structured consensus statement on good clinical practice in patients with neurological disease during the COVID‐19 pandemic that provides immediate guidance for neurologists. In this fast‐evolving pandemic, a rapid response using refined Delphi methodology is possible, but guidance may be subject to change as further evidence emerges.

Severe Acute Respiratory Syndrome Coronavirus 2-Induced Neurological Complications

“…People are encouraged to use masks or face coverings and to follow hand hygiene practices (Rabaan et al, 2020 ). Other the other hand, the management and treatment of acute or chronic primary neurological diseases cannot be neglected (von Oertzen et al, 2020 ). Task forces comprised of medical staff have been placed to guarantee emergency care of acute neurovascular events (Al-Jehani et al, 2020 ).…”

Multiple Sclerosis and SARS-CoV-2 Vaccination: Considerations for Immune-Depleting Therapies

“…The emergence of novel coronavirus infectious disease 2019 (COVID- 19), a complex clinical syndrome caused by severe acute respiratory disease type-2 (SARS-CoV-2), poses an ongoing challenge for neurologists caring for people with multiple sclerosis (pwMS) [1]. Uncertainty and anxiety are frequently expressed by the patients and caregivers and are underpinned by the question of whether MS as an independent comorbidity and the use of immunotherapies are associated with an increased risk of severe COVID-19 infection [2,3].…”

Clinical and Electrophysiological Outcome Measures of Patients With Post-Infectious Neurological Syndromes Related to COVID-19 Treated With Intensive Neurorehabilitation

“…Notwithstanding, a novelty of this study is represented by the in-depth description of clinical and electrophysiological aspects of patients with rare neurological manifestations of COVID-19 who underwent an intensive rehabilitation program and were followed up for a relatively long time period of 6 months. Current literature on COVID-19 is mainly focused on clinical manifestations and complications of the SARS-CoV-2 infection in the acute phase, while evidence regarding longterm outcome is still lacking (22,26,27). To our knowledge, this is the first report to suggest the important role of neurological rehabilitation intervention in COVID-19 patients with neurological impairment.…”