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Why individuals with cerebral palsy are at higher risk for respiratory complications from COVID-19

Joline E Brandenburg1,2, Matthew J Fogarty3, Gary C Sieck1,3

  • 1Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, MN, USA.

Journal of Pediatric Rehabilitation Medicine
|November 2, 2020
PubMed

Insights

Children with cerebral palsy (CP) may have impaired diaphragm function, increasing respiratory risks. This review examines diaphragm muscle function in CP and its implications for respiratory health, especially concerning COVID-19.

Area of Science:

  • Neurology
  • Respiratory Medicine
  • Developmental Pediatrics

Background:

  • Respiratory dysfunction is a major cause of illness and death in individuals with cerebral palsy (CP).
  • Impaired diaphragm muscle (DIAm) function is often overlooked in CP patients.
  • Individuals with CP and existing respiratory issues face higher risks from COVID-19.

Purpose of the Study:

  • To review current research on respiratory function and DIAm force generation in children with CP.
  • To compare clinical findings in CP with basic science research on phrenic motor neuron and DIAm motor unit dysfunction in a CP animal model (spa mouse).
  • To integrate clinical and basic science data to discuss potential severe respiratory symptoms in individuals with CP due to COVID-19.

Main Methods:

  • Review of clinical studies on respiratory function and DIAm strength in pediatric CP.
  • Comparison with basic science research on phrenic nerve and DIAm motor unit function in spa mice.
  • Integration of findings to assess COVID-19 respiratory risks in CP.

Main Results:

  • Children with CP exhibit impaired respiratory function and reduced DIAm force generation.
  • The spa mouse model shows dysfunction in phrenic motor neurons and DIAm motor units, mirroring CP symptoms.
  • Evidence suggests a heightened risk of severe respiratory complications from COVID-19 in individuals with CP.

Conclusions:

  • Impaired DIAm function is a significant, often overlooked, factor in respiratory morbidity in CP.
  • Combining clinical and animal model data provides a comprehensive understanding of respiratory challenges in CP.
  • Individuals with CP may be particularly vulnerable to severe respiratory outcomes from COVID-19, necessitating targeted clinical attention.

Keywords:
COVID-19Diaphragmcerebral palsymotor neuronrespiratory

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