COVID-19 and neuromuscular disorders

Amanda C Guidon; Anthony A Amato

doi:10.1212/WNL.0000000000009566

COVID-19 and neuromuscular disorders

Neurology. 2020 Jun 2;94(22):959-969. doi: 10.1212/WNL.0000000000009566. Epub 2020 Apr 13.

Authors

Amanda C Guidon¹, Anthony A Amato¹

Affiliation

¹ From the Division of Neuromuscular Medicine, Department of Neurology, Massachusetts General Hospital (A.C.G.), and Division of Neuromuscular Medicine, Department of Neurology, Brigham and Woman's Hospital (A.A.A.), Harvard Medical School, Boston, MA. aguidon@partners.org aamato@bwh.harvard.edu.

PMID: 32284362
DOI: 10.1212/WNL.0000000000009566

Abstract

The coronavirus 2019 (COVID-19) pandemic has potential to disproportionately and severely affect patients with neuromuscular disorders. In a short period of time, it has already caused reorganization of neuromuscular clinical care delivery and education, which will likely have lasting effects on the field. This article reviews (1) potential neuromuscular complications of COVID-19, (2) assessment and mitigation of COVID-19-related risk for patients with preexisting neuromuscular disease, (3) guidance for management of immunosuppressive and immunomodulatory therapies, (4) practical guidance regarding neuromuscular care delivery, telemedicine, and education, and (5) effect on neuromuscular research. We outline key unanswered clinical questions and highlight the need for team-based and interspecialty collaboration. Primary goals of clinical research during this time are to develop evidence-based best practices and to minimize morbidity and mortality related to COVID-19 for patients with neuromuscular disorders.

Publication types

Review

MeSH terms

Antiviral Agents / adverse effects
COVID-19
COVID-19 Vaccines
Chloroquine / adverse effects
Coronavirus Infections / complications
Coronavirus Infections / prevention & control
Coronavirus Infections / therapy*
Delivery of Health Care
Deprescriptions
Disease Progression
Drug Development
Enzyme Inhibitors / adverse effects
Guillain-Barre Syndrome / etiology
House Calls
Humans
Hydroxychloroquine / adverse effects
Immunologic Factors / adverse effects
Immunologic Factors / therapeutic use
Immunosuppressive Agents / adverse effects*
Immunosuppressive Agents / therapeutic use
Infusions, Subcutaneous
Macrolides / adverse effects
Muscular Diseases / etiology
Myasthenia Gravis / chemically induced
Neurology / education
Neuromuscular Diseases / complications
Neuromuscular Diseases / therapy*
Pandemics / prevention & control
Pneumonia, Viral / complications
Pneumonia, Viral / prevention & control
Pneumonia, Viral / therapy*
Practice Guidelines as Topic
Research
Risk Reduction Behavior
Self Administration
Telemedicine
Viral Vaccines / therapeutic use

Substances

Antiviral Agents
COVID-19 Vaccines
Enzyme Inhibitors
Immunologic Factors
Immunosuppressive Agents
Macrolides
Viral Vaccines
Hydroxychloroquine
Chloroquine