Background and purpose The recent SARS-CoV-2 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 fast-evolving
pandemic, evidence-based studies are lacking in many areas. This paper presents European
Academy of Neurology (EAN) expert consensus statements to guide neurologists caring
for patients with COVID-19. 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 co-chairs rated importance
on a five-point 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. Fifty-nine statements obtained >70%
agreement and were retained. In round three, responses were received from 55 co-chairs
of 29 SPs. Whilst general recommendations related to prevention of COVID-19 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 COVID-19 pandemic
that provides immediate guidance for neurologists. In this fast-evolving pandemic,
a rapid response using refined Delphi methodology is possible, but guidance may be
subject to change as further evidence emerges.
