Abstract
Since the emergence of SARS-CoV-2, several studies have been published describing neuromuscular manifestations of the disease, as well as management of pre-existing pediatric neuromuscular disorders during the COVID-19 pandemic. These disorders include muscular dystrophies, myasthenic syndromes, peripheral nerve disorders, and spinal muscular atrophy. Such patients are a vulnerable population due to frequent complications such as scoliosis, cardiomyopathy, and restrictive lung disease that put them at risk of severe complications of COVID-19. In this review, neuromuscular manifestations of COVID-19 in children and the management of pre-existing pediatric neuromuscular disorders during the COVID-19 pandemic are discussed. We also review strategies to alleviate pandemic-associated disruptions in clinical care and research, including the emerging role of telemedicine and telerehabilitation to address the continued special needs of these patients.
Highlights
Confounding evidence came from a small case series of 29 children with neuromuscular disorders (NMDs) reported by the Neuromuscular Working Group of Spanish Pediatric Neurologic Society
This includes through formal guidelines such as those released for neurophysiology labs in Canada, highlighting infection control procedures with individualized recommendations for EMG and nerve conduction studies [46]
During the ongoing COVID-19 pandemic, expert guidance should be followed for the management of patients with pre-existing spinal muscular atrophy (SMA), muscular dystrophies, and myasthenia gravis
Summary
The ongoing COVID-19 pandemic has complicated the care of pediatric neuromuscular disorders (NMDs) in numerous ways. An ad hoc group of specialists published a set of ethical principles regarding ongoing care of pediatric neuromuscular patients, especially in the setting. Pediatric patients with an anticipated prolonged recovery or those requiring resource-intensive treatment have similar chances of returning to their previous baseline, and should not be disadvantaged during triage. Triage officers should make ready use of clinicians and advanced practice providers with relevant expertise due to the broad range of pediatric neuromuscular conditions. These patients have higher baseline medical needs. Perceived worsening was attributed to disrupted access to care, social isolation, and mental health challenges such as anxiety and depression
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