Table 1.

Neuromuscular disorders management in Covid-19 era.

- Encourage telematics assessments     ° Monitoring home ventilation     ° Perform respiratory assessments if able - Do not stop rehabilitation - Psychological support (specially in DMD with behavioral disorders) - Perform EDX safely and DO NOT delay diagnosis - Consider clinical trial monitoring remotely - Patients under steroids treatment: do not stop steroids and consider increasing the dose in ill patients - Rationalize the use of IS agents     ° Space doses or postpone the initiation if stable (especially if the infusion is in the hospital: cyclophosphamide, rituximab, etc.)     ° Choose IS with a safer profile. Do not stop IACE drugs     ° Consider switching IVIG to subcutaneous immunoglobulins     ° Consider PLEX or IG as an alternative option instead steroids in CIDP patients     ° For maintenance rituximab therapy, consider delaying the infusion     ° even beyond 6 months, if the CD19 and CD20 lymphocytes are suppressed - Consider anticoagulant prophylaxis in patients with COVID-19 that require also IVIG - Continue ASO treatment as scheduled in SMA patients - Do not stop IACE drugs (DMD/BMD) - Avoid chloroquine, hydroxychloroquine (DMD/BMD and MG) and azithromycin (MG)

Summary of recommendations for the management of neuromuscular diseases. MG, myasthenia gravis; DMD/BMD, Duchenne/Becker muscular dystrophy; SMA, spinal muscular atrophy; ALS, amyotrophic lateral sclerosis, IS, immunosuppressants; IG, immunoglobulin; IVIG, intravenous immunoglobulin; PLEX, plasmapheresis; IACE, angiotensin-converting enzyme inhibitors; ASO, antisense oligonucleotide.