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


Journal

European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311

Informations de publication

Date de publication:
01 2021
Historique:
received: 25 06 2020
revised: 20 08 2020
accepted: 31 08 2020
pubmed: 16 10 2020
medline: 8 1 2021
entrez: 15 10 2020
Statut: ppublish

Résumé

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. 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. 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. 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.

Sections du résumé

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.

Identifiants

pubmed: 33058321
doi: 10.1111/ene.14521
pmc: PMC7675361
doi:

Types de publication

Guideline Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

7-14

Informations de copyright

© 2020 The Authors. European Academy of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

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Auteurs

T J von Oertzen (TJ)

Faculty of Medicine, Johannes-Kepler Universität, Linz, Austria.
Department of Neurology 1, Kepler Universitätsklinikum, Linz, Austria.

A Macerollo (A)

Walton Centre NHS Foundation Trust, Liverpool, UK.
Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.

M A Leone (MA)

UO Neurologia, Fondazione IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Italy.

E Beghi (E)

Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.

M Crean (M)

European Academy of Neurology, Head Office, Vienna, Austria.

S Oztuk (S)

Department of Neurology, Faculty of Medicine, Selcuk University, Konya, Turkey.

C Bassetti (C)

Department of Neurology, Inselspital, University of Bern, Bern, Switzerland.

A Twardzik (A)

European Academy of Neurology, Head Office, Vienna, Austria.

D Bereczki (D)

Department of Neurology, Semmelweis University, Budapest, Hungary.

G Di Liberto (G)

Department of Pathology and Immunology, Geneva Faculty of Medicine, Geneva, Switzerland.

R Helbok (R)

Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.

C Oreja-Guevara (C)

Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain.
Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain.
IdISSC, Madrid, Spain.

A Pisani (A)

Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.

A Sauerbier (A)

Department of Neurology, University Hospital Cologne, Cologne, Germany.

J Sellner (J)

Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria.
Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.
Department of Neurology, Klinikum rechts der Isar, Technische Universität München, München, Germany.

R Soffietti (R)

Division of Neuro-Oncology, Department of Neuroscience, University of Turin, Turin, Italy.

M Zedde (M)

Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.

E Bianchi (E)

Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.

B Bodini (B)

Department of Neurology, Saint-Antoine Hospital, APHP, Sorbonne University, Paris, France.

F Cavallieri (F)

Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Reggio Emilia, Italy.

L Campiglio (L)

Division of Neurology, 'Aldo Ravelli' Research Center, Department of Neurology, University of Milan and ASST Santi Paolo e Carlo, Milan, Italy.

L F Maia (LF)

Department of Neurology, Centro Hospitalar Universitário do Porto, Porto, Portugal.

A Priori (A)

Division of Neurology, 'Aldo Ravelli' Research Center, Department of Neurology, University of Milan and ASST Santi Paolo e Carlo, Milan, Italy.

M Rakusa (M)

Department of Neurology, University Medical Centre Maribor, Maribor, Slovenia.

P Taba (P)

Department of Neurology and Neurosurgery, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.

E Moro (E)

Division of Neurology, CHU of Grenoble, Grenoble Alpes University, Grenoble Institute of Neurosciences, Grenoble, France.

T M Jenkins (TM)

Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK.
Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

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