The frequency, determinants, and evolution of neurological manifestations associated with coronavirus disease 2019 (COVID-19) remain unknown, because of few available data and the retrospective nature of most reports.1, 2, 3, 4 Furthermore, the possible neurotropic nature of the virus (leading to dyspnoea and respiratory failure) is yet to be confirmed.5
Neurologists are facing many other challenges in the current pandemic, including the management of older patients and those with pre-existing neurological disorders for whom ethical decisions about escalation of care (eg, admission to an intensive-care unit or intubation) might be difficult.
The European Academy of Neurology (EAN) aims to gather evidence about the neurological impact of COVID-19. Encompassing 45 000 European neurologists, 47 European National Neurological Societies, and ten associate National Societies from Africa and Asia, the EAN has created a multidisciplinary task force, the EANcore COVID-19, to develop: diagnostic and treatment recommendations for patients with COVID-19 with all subgroups of neurological condition; an online Neuro COVID-19 survey on neurological complications of COVID-19 (for which more than 4200 responses have been already received as of April 30, 2020); and the EAN Neuro COVID-19 registry, which arises from a collaboration with the Italian, Spanish, and Portuguese neurological societies and aims to collect standardised information about demographics, comorbidities, general and neurological manifestations, and course and outcome of COVID-19. This registry, launched on April 29, 2020, will be offered by the EAN to all interested neurologists, neurology departments, and National Societies, together with the necessary ethical, methodological, and technical support. EAN will also provide a platform for rapid COVID-19-related literature alerts and information.
Difficult times ask for innovative and courageous solutions. Neurologists are called on to play their part. The EAN is ready to support and join international efforts to alleviate the medical consequences and also the burden associated with the COVID-19 pandemic.
Acknowledgments
All authors declare no competing interests.
References
- 1.Mao L, Lin H, Wang M. Neurologic manifestation of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020 doi: 10.1001/jamaneurol.2020.1127. published online April 10. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Toscano G, Palmerini F, Ravaglia S. Guillain-Barré syndrome associated with SARS-CoV-2. N Engl J Med. 2020 doi: 10.1056/NEJMc2009191. published online April 17. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Gutierrez-Ortiz C, Mendez A, Rodrigo-Rey S. Miller-Fisher syndrome and polyneuritis cranialis in COVID-19. Neurology. 2020 doi: 10.1212/WNL.0000000000009619. published online April 17. [DOI] [PubMed] [Google Scholar]
- 4.Helms J, Kremer S, Merdji H. Neurologic features in severe SARS-CoV-2 infection. N Engl J Med. 2020 doi: 10.1056/NEJMc2008597. published online April 15. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020 doi: 10.1002/jmv.25728. published online Feb 27. [DOI] [PMC free article] [PubMed] [Google Scholar]