Changing Paradigm of Care of Neuromuscular Diseases in the COVID-19 Pandemic: A Scoping Review

Background: In the current clinical scenario, people living with neuromuscular diseases (NMD) represent a vulnerable category with a high risk of severe course of COVID-19. Management of NMDs has become a challenge since most of them are chronic, disabling, progressive, and/or require immunosuppressive drugs. This scoping review aims to bring forth crucial queries for general neurologists and specialists dealing with NMD patients in the time of COVID-19 and highlight the research areas in a novel pandemic situation.
Methods: This scoping review was conducted according to the PRISMA- ScR statement. 18 research articles on neuromuscular disorders and effects of Covid-19 pandemic on rehabilitation and quality of life of these patients were included.
Results: Currently, clinical data regarding the effects of COVID-19 on people with NMDs and their risk of contracting the infection or experiencing severe manifestations of COVID-19 is scarce. There are notable differences in responses to disruptions across the world. The existing care delivery model from medical and on a continuum to rehabilitation is inherently different. The technological services in developing countries seem to be potentially compromised and unexplored to a great extent.
Conclusion: COVID-19 has already caused reorganization of neuromuscular clinical care delivery and education, likely having a lasting impact on the field. This paradigm shift has impacted all sectors of clinical, rehabilitation and research avenues of patients with NMD. Evolving healthcare delivery models in neurology during the pandemic are promising. After the initial phase of rapid adjustments, countries are now coming up with practical recommendations addressing the care of NMD patients during the pandemic. With this, patients with neuromuscular conditions can continue high level medical and rehabilitation care to remain healthy and thrive, during this pandemic.

Keywords:Neuromuscular diseases; Pandemic; COVID-19; Care, quality of life; Rehabilitation; Scoping review

Abbreviations:WHO: World Health Organisation; NMD: Neuromuscular Diseases; DMD: Duchenne Muscle Dystrophy; MG: Myasthenia Gravis; SMA: Spinal Muscle Atrophy; PA: Physical activity; QOL: Quality of Life