. 2020 Jun 5;62(2):182–186. doi: 10.1002/mus.26989

TABLE 4.

COVID‐19 challenges and opportunities in ALS care and research

Challenges	Opportunities
Inability to offer face‐to‐face clinic and research visits	• Capitalize on the large growth in telemedicine availability, at least for follow‐up clinic patients and research patients
Inability to perform spirometry, including vital capacity which is used as an inclusion criteria in trials, and to plan timing of several care options (eg, NIV initiation)	• Use home‐based spirometry • Develop alternative measures that correlate well with spirometry but are simpler and carry no increases risk of infection (eg, counting out loud, vocalizing a sound)
Limited availability of several evidence‐ and experience‐based ALS care options	• Capitalize on previous work showing that multidisciplinary ALS care is possible via telemedicine • Account for variability in care options across different trial sites

Challenges

Opportunities

Inability to offer face‐to‐face clinic and research visits

• Capitalize on the large growth in telemedicine availability, at least for follow‐up clinic patients and research patients

Inability to perform spirometry, including vital capacity which is used as an inclusion criteria in trials, and to plan timing of several care options (eg, NIV initiation)

• Use home‐based spirometry

• Develop alternative measures that correlate well with spirometry but are simpler and carry no increases risk of infection (eg, counting out loud, vocalizing a sound)

Limited availability of several evidence‐ and experience‐based ALS care options

• Capitalize on previous work showing that multidisciplinary ALS care is possible via telemedicine

• Account for variability in care options across different trial sites

Abbreviations: ALS, amyotrophic laterial sclerosis; COVID‐19, coronavirus 2019; NIV, noninvasive ventilation.