COVID-19 and NM Disorders-Dr. Amato - COVID-19 and Neuromuscular Disorder

Dr. Amato - COVID-19 and Neuromuscular Disorder

Pdf Summary

The document discusses the potential neuromuscular complications of COVID-19 and provides guidance for the assessment and management of patients with pre-existing neuromuscular disorders. It also addresses the risks of immunosuppressive and immunomodulatory therapies, practical guidance for delivering neuromuscular care during the pandemic, and the impact of COVID-19 on neuromuscular research.<br /><br />In terms of neuromuscular complications, COVID-19 has been associated with conditions such as Guillain-Barre syndrome (GBS), myositis, and critical illness myopathy or polyneuropathy. It can also exacerbate known or unmask previously unrecognized neuromuscular disorders, including autoimmune disorders and degenerative disorders.<br /><br />The document discusses the risks of immunosuppressant and immunomodulating therapies for patients with autoimmune neuromuscular disorders. These therapies may increase the risk of COVID-19 infection and more severe disease. They may also increase the risks and severity of other infections in patients with COVID-19 and may affect the efficacy of vaccines.<br /><br />The risks of treatments for COVID-19 are also discussed. For example, drugs like hydroxychloroquine and chloroquine can cause toxic neuropathy and myopathy. Antiviral treatments such as lopinavir/ritonavir and remdesivir may also have potential risks.<br /><br />The document highlights the potential risks and considerations related to vaccinations. It discusses the possibility of an increased risk of Guillain-Barre syndrome (GBS) with adenovirus vector vaccines, although no signal has been observed with mRNA vaccines. The utility of vaccinations in immunosuppressed patients and timing considerations are also discussed.<br /><br />The document includes case studies and findings from autopsy studies that provide further insights into COVID-19-associated neuromuscular manifestations. It discusses muscle pathology, the presence of inflammatory markers, and the lack of direct viral infection of muscle fibers.<br /><br />Overall, the document provides a comprehensive overview of the potential neuromuscular complications of COVID-19, the management of patients with pre-existing neuromuscular disorders, and the risks and considerations related to treatments and vaccinations.

Keywords

neuromuscular complications

COVID-19

assessment

management

pre-existing neuromuscular disorders

immunosuppressive therapies

immunomodulatory therapies

neuromuscular care

pandemic

neuromuscular research