Neurological condition

Vulnerability

References

No increased risk, provided the breathing and swallowing muscles are functioning well. Increases to very high with reduced mobility and frailty.

not at increased risk of acquiring infection but at increased risk of severe symptoms.  Very high risk if swallowing difficulties , taking immuno-suppressants, reduced mobility, other co-morbidity

Not at increased risk of infection.  Only at increased risk of complications if neurological impairment

likely to be low in working population

same risk as the general public‘ unless requiring CPAP or NIV or suffering vocal paralysis

https://cdn.ymaws.com/www.theabn.org/resource/collection/6750BAE6-4CBC-4DDB-A684-116E03BFE634/ABN_Neurology_COVID-19_Guidance_22.3.20.pdf

No risk to uncomplicated Charcot-Marie-Tooth

no evidence of particular risk, but Down’s syndrome may be more at risk from infections generally and respiratory infections in particular. Consider co-morbidity;- respiratory conditions, heart disease, diabetes, and immunodeficiency. A number of those with Down’s syndrome will fall within these higher risk groups.

Employees with mild to moderate epilepsy, with no breathing or swallowing difficulties, are unlikely to be at increased risk from COVID-19

https://www.theabn.org/news/495261/ABN-Guidance-on-COVID-19-for-people-with-neurological-conditions.htm

depends on co-morbidity and impairment

Lack of evidence available. Immunosuppression not usually a feature, but there may be co-morbidities increasing risk.

in general not at increased risk other unless other co-morbid conditions

but increased if BMI >40, common in this group

Azathioprine

Methotrexate

Mycophenolate mofetil

Combined with oral prednisolone ≥ 20mg daily

https://cdn.ymaws.com/www.theabn.org/resource/collection/6750BAE6-4CBC-4DDB-A684-116E03BFE634/ABN_Neurology_COVID-19_Guidance_22.3.20.pdf

Infliximab

Ocrelizumab

Rituximab

Encephalitis

Neuro-sarcoidosis

Vasculitis

Risk conferred by immunosuppression and also by any co-morbidities [e.g. renal or lung disease] Some patients may have bulbar or respiratory weakness that confers additional risk

Chronic inflammatory demyelinating poly neuropathy and amyloid / paraprotein neuropathies

Immunoglobulin does not increase the risk of infection.  Risk conferred by immunosuppression.  High risk if cardiac involvement in amyloid disease

risk of decompensation or cardiomyopathy

particularly patients with bulbar or respiratory muscle weakness

https://www.mndassociation.org/shielding-and-protecting-vulnerable-persons-from-covid-19/

Immunosuppression combined with oral prednisolone ≥ 20mg daily

Immunosuppression

No medication

Very high

High

Low

https://www.theabn.org/news/495261/ABN-Guidance-on-COVID-19-for-people-with-neurological-conditions.htm

MS patients are not significantly at risk from COVID-19, unless they have advanced disability with swallowing or breathing difficulties, or they are receiving selected immunotherapies.

https://cdn.ymaws.com/www.theabn.org/resource/collection/6750BAE6-4CBC-4DDB-A684-116E03BFE634/ABN_Guidance_on_DMTs_for_MS_and_COVID19_APPROVED_11_March.pdf

includes specific MS drug guidance

Myositis

Polymyositis

Increased risk due to respiratory muscle weakness + co-existing interstitial lung disease which is common in these patients and other overlap connective tissue disorders. May be on steroids or other immunosuppression.

Becker

Duchenne

Limb girdle dystrophies

X-linked etc.

Increased risk due to respiratory muscle weakness + co-existing interstitial lung disease which is common in these patients and other overlap connective tissue disorders. May have weak cough or cardiomyopathy.

Very high if FVC<60%.

Congenital myasthenia with previous respiratory involvement or needing nocturnal ventilation

Lambert Eaton myasthenic syndrome with substantial respiratory involvement

Immunosuppression plus Prednisolone ≥ 20mg daily

Lambert Eaton myasthenic syndrome without substantial respiratory involvement

On immunosuppression

Ocular myasthenia

Well controlled adult congenital myasthenia without respiratory involvment in the last 10 years and normal sleep studies

Parkinson’s itself does not put you in the extremely vulnerable group but there is an increased risk of complications. Likely to be very high if significant disability / advanced disease / in care

No evidence of increased risk unless immunosuppressed, respiratory or swallowing issues or other co-morbidities

in general not at increased risk other unless other co-morbid conditions