A call from the European Academy of Neurology on COVID-19

European Academy of Neurology: First 10 years

The European Academy of Neurology (EAN) was founded in May 2014 as the scientific society of all neurologists and all national neurological societies in Europe. The creation of EAN was based on the conscious decision of two predecessor societies (the European Federation of Neurological Societies and the European Neurological Society) to have a unique society for this continent with its 53 countries according to the World Health Organization and with the EU as the most important continental political decision level. In this report, the important milestones and the motivations of the decision-makers during the first 10 years are described. The development of the annual congress, the broad educational agenda, and the scientific groundwork including the European guidelines for the practise of neurology are described. Collaboration with and work for the national neurological societies is an important task for EAN. The political representation of neurology in Brussels and collaboration with the scientific societies of neighbouring medical disciplines and patient organizations are other major tasks on the agenda of the organization. EAN's goal is to reduce the burden of neurological diseases and to be the "home of neurology" in Europe for physicians, patients, and society. EAN communicates and interacts with its members, patients, partners, politicians, and the public through different channels. EAN is the owner of the scientifically independent European Journal of Neurology. EAN is based in Vienna, where its head office is located, but is also strongly represented in Brussels.

The European Academy of Neurology NeuroCOVID-19 Task Force: A lesson for the future

BACKGROUND

The COVID-19 pandemic has made its mark on world history forever causing millions of deaths, and straining health systems, economies, and societies worldwide. The European Academy of Neurology (EAN) reacted promptly. A special NeuroCOVID-19 Task Force was set up at the beginning of the pandemic to promote knowledge, research, international collaborations, and raise awareness about the prevention and treatment of COVID-19-related neurological issues.

METHODS

Activities carried out during and after the pandemic by the EAN NeuroCOVID-19 Task Force are described. The main aim was to review all these initiatives in detail as an overarching lesson from the past to improve the present and be better prepared in case of future pandemics.

RESULTS

During the pandemic, the Task Force was engaged in several initiatives: the creation of the EAN NEuro-covid ReGistrY (ENERGY); the launch of several surveys (neurological manifestations of COVID-19 infection; the pandemic's impact on patients with chronic neurological diseases; the pandemic's impact of restrictions for clinical practice, curricular training, and health economics); the publication of position papers regarding the management of patients with neurological diseases during the pandemic, and vaccination hesitancy among people with chronic neurological disorders; and the creation of a dedicated "COVID-19 Breaking News" section in EANpages.

CONCLUSIONS

The EAN NeuroCOVID-19 Task Force was immediately engaged in various activities to participate in the fight against COVID-19. The Task Force's concerted strategy may serve as a foundation for upcoming global neurological emergencies.

The COVID-19 pandemic, an environmental neurology perspective

Neurologists have a particular interest in SARS-CoV-2 because the nervous system is a major participant in COVID-19, both in its acute phase and in its persistent post-COVID phase. The global spread of SARS-CoV-2 infection has revealed most of the challenges and risk factors that humanity will face in the future. We review from an environmental neurology perspective some characteristics that have underpinned the pandemic. We consider the agent, SARS-CoV-2, the spread of SARS-CoV-2 as influenced by environmental factors, its impact on the brain and some containment measures on brain health. Several questions remain, including the differential clinical impact of variants, the impact of SARS-CoV-2 on sleep and wakefulness, and the neurological components of Long-COVID syndrome. We touch on the role of national leaders and public health policies that have underpinned management of the COVID-19 pandemic. Increased awareness, anticipation and preparedness are needed to address comparable future challenges.

European Academy of Neurology 2022

INTRODUCTION

With its last two virtual congresses attracting an increasing number of participants 43,844 attendees at the Virtual Congress in 2020 (registration free of charge) and 11,095 attendees at the Virtual Congress in 2021 (with an affordable range of registration fees), EAN has seen consistent growth over the past three years.

RESULTS

Going beyond the congress, EAN has launched many initiatives towards its strategic priorities during this three-year period, from an international neuro-covid patient registry, novel research projects such as one assessing the burden of Sleep/Wake disorders in Europe, state-of-the-art eLearning to steadfast advocacy for the importance of neurology via international collaboration and EAN's recently launched Brain Health Strategy, calling for a holistic approach to reducing the burden of neurological disorders.

DISCUSSION

The EAN board has recently assessed future needs and challenges with initiatives including a clinical neuroscience fellowship programme and mapping of clinical neuroscience PhD programmes, along with developing a common educational trunk with related disciplines, featuring as potential future options. EAN will also continue to strengthen international and interdisciplinary collaboration into the future.

The EAN Brain Health Strategy: One Brain, One Life, One Approach

BACKGROUND

Brain health is essential for health, well-being productivity and creativity across the entire life. Its definition goes beyond the absence of disease embracing all cognitive, emotional, behavioural and social functions which are necessary to cope with life situations.

METHODS

The EAN Brain Health Strategy responds to the high and increasing burden of neurological disorders. It aims to develop a non-disease, non-age centred holistic and positive approach ('one brain, one life, one approach') to prevent neurological disorders (e.g., Alzheimer's disease and other dementias, stroke, epilepsy, headache/migraine, Parkinson's disease, multiple sclerosis, sleep disorders, brain cancer) but also to preserve brain health and promote recovery after brain damage.

RESULTS

The pillars of the EAN Brain Health strategy are: 1) Contribute to a global and international Brain Health approach (together with national and subspecialty societies, other medical societies, WHO, WFN, patients' organizations, industry, and other stakeholders); 2) Supporting the 47 European national societies, healthcare and policymakers in the implementation of integrated and people-centred campaigns; 3) Fostering Research (e.g. on prevention of neurological disorders, determinants and assessments of brain health), 4) Promoting Education of students, neurologists, general practitioners, other medical specialists and health professionals, patients, caregivers, and general public; 5) Raising public awareness of neurological disorders and brain health.

CONCLUSIONS

By adopting this 'one brain, one life, one approach' strategy in cooperation with partner societies, international organisations, and policymakers, a significant number of neurological disorders may be prevented while enhancing the overall well-being of individuals by maintaining brain health through the life course.

Continuing Medical Education (CME) in time of crisis: How medical societies face challenges and adapt to provide unbiased CME

Healthcare professionals need to maintain their knowledge and skills to deliver the best possible care to patients. Medical societies play an important role as providers of continuing medical education (CME) and have actively continued this role during the COVID-19 pandemic adapting the delivery of education to virtual meetings and courses. The Biomedical Alliance in Europe CME Experts Committee conducted two surveys to collect information on the delivery of CME, generally, and during the COVID-19 pandemic from the member medical societies. In this article, we will present the most relevant data collected and share some reflections based on this analysis.

Immunosuppression in chronic autoimmune neurological disorders during the COVID-19 pandemic

OBJECTIVE

To study the risk of acquiring Corona Virus Disease 2019 (COVID-19) and its outcomes in patients on immunosuppressive therapy (IST) for chronic autoimmune neuromuscular disorders (aNMD) and multiple sclerosis (MS).

METHODS

We used TriNetX, a global health collaborative clinical research platform collecting real-time electronic medical records data, which has one of the largest known global COVID-19 database. We included patients with chronic autoimmune neuromuscular disorders (aNMD) [myasthenia gravis (MG), inflammatory myositis, and chronic inflammatory neuropathies (CIN)] and MS, based on the International Classification of Disease-10 (ICD-10) coding for one year before January 20th, 2020. We examined the use of IST, rate of COVID- 19, hospitalization, intubation, and mortality among the patients with aNMD and MS.

RESULTS

A total of 33,451 patients with aNMD and 42,899 patients with MS were included. Among them, 111 (0.33%) patients with aNMD and 115 patients (0.27%) with MS had COVID-19. About one third of them required hospitalization. IST did not appear to have a significant impact on overall infection risk in either group; however, risk of hospitalization for immunosuppressed patients with aNMD was higher (Odds ratio 2.86, p-value 0.011).

CONCLUSIONS

IST use does not appear to make patients with aNMD and MS more vulnerable to COVID-19. IST may be continued during the pandemic, as previously suggested by expert opinion guidelines. However, it is important to consider individualizing immunotherapy regimens in some cases. Additional physician reported registry-based data is needed to further confirm these findings.

EAN consensus statement for management of patients with neurological diseases during the COVID-19 pandemic

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.

EAN congress highlights challenges - predict, prevent, repair

After going virtual, the European Academy of Neurology 2020 Congress became the biggest neurology meeting in history. The overarching theme was ‘Time for action: predict, prevent, repair’ — three upcoming Reviews in Nature Reviews Neurology, written by speakers at the congress, highlight the importance of the theme across neurology.