Management challenges for chronic dysimmune neuropathies during the COVID-19 pandemic

Yusuf A. Rajabally*, H. Stephan Goedee, Shahram Attarian, Hans Peter Hartung

*Corresponding author for this work

Research output: Contribution to journalLetter, comment/opinion or interviewpeer-review


Since March 2020, the COVID-19 pandemic has led to the need to re-think the delivery of services to patients with chronic dysimmune neuropathies. Telephone/video consultations have become widespread but have compounded concerns about objective evaluation. Therapeutic decisions need, more than ever before, to be considered in the best interests of both patients, and society, while not denying function-preserving/restoring treatment. Immunoglobulin therapy and plasma exchange, for those treated outside of the home, expose patients to the hazards of hospital or outpatient infusion centers. Steroid therapy initiation and continuation pose increased infectious risk. Immunosuppressant therapy similarly becomes highly problematic, with the risks of treatment continuation enhanced by uncertainties regarding duration of the pandemic. The required processes necessitate considerable time and effort especially as resources and staff are re-deployed to face the pandemic, but are essential for protecting this group of patients and as an integral part of wider public health actions.

Original languageEnglish
Pages (from-to)34-40
Number of pages7
JournalMuscle and Nerve
Issue number1
Early online date20 Apr 2020
Publication statusPublished - 1 Jul 2020


  • chronic inflammatory demyelinating polyneuropathy
  • COVID-19
  • dysimmune
  • multifocal motor neuropathy
  • pandemic
  • paraproteinemic neuropathy
  • Pandemics
  • Humans
  • Polyneuropathies/complications
  • Pneumonia, Viral/complications
  • Autoimmune Diseases of the Nervous System/complications
  • Betacoronavirus
  • Coronavirus Infections/complications
  • Disease Management


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