European Journal of Neurology / EAN consensus statement for management of patients with neurological diseases during the COVID19 pandemic

Background and purpose: The recent SARSCoV2 pandemic has posed multiple challenges to the practice of clinical neurology including recognition of emerging neurological complications and management of coexistent neurological diseases. In a fastevolving pandemic, evidencebased studies are lacking in many areas. This paper presents European Academy of Neurology (EAN) expert consensus statements to guide neurologists caring for patients with COVID19. Methods: A refined Delphi methodology was applied. In round 1, statements were provided by EAN scientific panels (SPs). In round 2, these statements were circulated to SP members not involved in writing them, asking for agreement/disagreement. Items with agreement >70% were retained for round 3, in which SP cochairs rated importance on a fivepoint Likert scale. Results were graded by importance and reported as consensus statements. Results: In round one, 70 statements were provided by 23 SPs. In round two, 259/1061 SP member responses were received. Fiftynine statements obtained >70% agreement and were retained. In round three, responses were received from 55 cochairs of 29 SPs. Whilst general recommendations related to prevention of COVID19 transmission had high levels of agreement and importance, opinion was more varied concerning statements related to therapy. Conclusion: This is the first structured consensus statement on good clinical practice in patients with neurological disease during the COVID19 pandemic that provides immediate guidance for neurologists. In this fastevolving pandemic, a rapid response using refined Delphi methodology is possible, but guidance may be subject to change as further evidence emerges. (VLID)5891876 Version of record