Guidance for the care of neuromuscular patients during the COVID-19 pandemic outbreak from the French Rare Health Care for Neuromuscular Diseases Network.
Angiotensin Receptor Antagonists
/ therapeutic use
Angiotensin-Converting Enzyme Inhibitors
/ therapeutic use
Anti-Bacterial Agents
/ therapeutic use
Antimalarials
/ therapeutic use
Azithromycin
/ therapeutic use
Betacoronavirus
COVID-19
Cardiorespiratory Fitness
Coronavirus Infections
/ drug therapy
Emergency Treatment
France
/ epidemiology
Glycogen Storage Disease Type II
/ therapy
Hospitalization
Humans
Hydroxychloroquine
/ therapeutic use
Immune System Diseases
/ therapy
Immunoglobulins, Intravenous
/ therapeutic use
Immunosuppressive Agents
/ therapeutic use
Muscular Atrophy, Spinal
/ drug therapy
Neuromuscular Diseases
/ therapy
Oligonucleotides
/ therapeutic use
Pandemics
Physical Therapy Modalities
Pneumonia, Viral
/ drug therapy
Prognosis
RNA, Small Interfering
/ therapeutic use
SARS-CoV-2
Steroids
/ therapeutic use
Withholding Treatment
alpha-Glucosidases
/ therapeutic use
COVID-19
Guidelines
Management
Neuromuscular
Treatment
Journal
Revue neurologique
ISSN: 0035-3787
Titre abrégé: Rev Neurol (Paris)
Pays: France
ID NLM: 2984779R
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
16
04
2020
revised:
16
04
2020
pubmed:
2
5
2020
medline:
12
6
2020
entrez:
2
5
2020
Statut:
ppublish
Résumé
In France, the epidemic phase of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in February 2020 and resulted in the implementation of emergency measures and a degradation in the organization of neuromuscular reference centers. In this special context, the French Rare Health Care for Neuromuscular Diseases Network (FILNEMUS) has established guidance in an attempt to homogenize the management of neuromuscular (NM) patients within the French territory. Hospitalization should be reserved for emergencies, the conduct of treatments that cannot be postponed, check-ups for which the diagnostic delay may result in a loss of survival chance, and cardiorespiratory assessments for which the delay could be detrimental to the patient. A national strategy was adopted during a period of 1 to 2months concerning treatments usually administered in hospitalization. NM patients treated with steroid/immunosuppressants for a dysimmune pathology should continue all of their treatments in the absence of any manifestations suggestive of COVID-19. A frequently asked questions (FAQ) sheet has been compiled and updated on the FILNEMUS website. Various support systems for self-rehabilitation and guided exercises have been also provided on the website. In the context of NM diseases, particular attention must be paid to two experimental COVID-19 treatments, hydroxycholoroquine and azithromycin: risk of exacerbation of myasthenia gravis and QT prolongation in patients with pre-existing cardiac involvement. The unfavorable emergency context related to COVID-19 may specially affect the potential for intensive care admission (ICU) for people with NMD. In order to preserve the fairest medical decision, a multidisciplinary working group has listed the neuromuscular diseases with a good prognosis, usually eligible for resuscitation admission in ICU and, for other NM conditions, the positive criteria suggesting a good prognosis. Adaptation of the use of noninvasive ventilation (NIV) make it possible to limit nebulization and continue using NIV in ventilator-dependent patients.
Identifiants
pubmed: 32354651
pii: S0035-3787(20)30523-3
doi: 10.1016/j.neurol.2020.04.004
pmc: PMC7167585
pii:
doi:
Substances chimiques
Angiotensin Receptor Antagonists
0
Angiotensin-Converting Enzyme Inhibitors
0
Anti-Bacterial Agents
0
Antimalarials
0
Immunoglobulins, Intravenous
0
Immunosuppressive Agents
0
Oligonucleotides
0
RNA, Small Interfering
0
Steroids
0
Hydroxychloroquine
4QWG6N8QKH
patisiran
50FKX8CB2Y
nusinersen
5Z9SP3X666
Azithromycin
83905-01-5
GAA protein, human
EC 3.2.1.20
alpha-Glucosidases
EC 3.2.1.20
Types de publication
Practice Guideline
Langues
eng
Sous-ensembles de citation
IM
Pagination
507-515Informations de copyright
Copyright © 2020 Elsevier Masson SAS. All rights reserved.
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