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.
Neurology. 2020 Jun 2;94(22):959-969. doi: 10.1212/WNL.0000000000009566. Epub 2020 Apr 13.
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.
2019 年冠状病毒(COVID-19)大流行有可能不成比例且严重地影响神经肌肉疾病患者。在短时间内,它已经导致神经肌肉临床护理的重新组织和教育,这可能对该领域产生持久的影响。本文综述了(1)COVID-19 的潜在神经肌肉并发症,(2)评估和减轻患有神经肌肉疾病的患者的 COVID-19 相关风险,(3)免疫抑制和免疫调节治疗管理的指南,(4)关于神经肌肉护理提供、远程医疗和教育的实用指南,以及(5)对神经肌肉研究的影响。我们概述了关键的未解答的临床问题,并强调需要团队合作和跨专业协作。在此期间,临床研究的主要目标是制定基于证据的最佳实践,并最大限度地减少 COVID-19 对神经肌肉疾病患者的发病率和死亡率。