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Impact of COVID-19 lockdown in children with neurological disorders in Italy
Stefania Maria Bova1, Martina Basso1, Marta Francesca Bianchi1
1Child Neurology Unit, Vittore Buzzi Children's Hospital, Università di Milano, via Castelvetro 32, 20154, Milano, Italy.
Insights
Lockdown measures protected children with neurological disorders from infections, though some experienced worsened conditions. Telemedicine offered a viable, but not definitive, care alternative for this vulnerable population.
Area of Science:
- Pediatrics
- Neurology
- Public Health
Background:
- Neurologically impaired children are a vulnerable group with unique health and protection needs.
- Full lockdown measures present debated costs and benefits, particularly for at-risk populations.
- Understanding lockdown's impact on children with neurological disorders is crucial for public health planning.
Purpose of the Study:
- To assess the effects of lockdown on the health of children with neurological disorders.
- To evaluate children with neurological disorders' access to healthcare services during lockdown.
- To identify risk factors for viral-like symptoms in this population during lockdown.
Main Methods:
- Physician-administered interviews collected data from 514 children (282 males, 232 females).
- Investigated viral-like symptoms, neurological condition changes, and healthcare access.
- Analyzed correlations between symptoms and demographic/clinical variables.
Main Results:
- 49.1% experienced symptoms, but no severe complications; symptom prevalence was lower during lockdown than prior months.
- 11.5% of patients experienced a worsening of their underlying neurological condition.
- Access to care was impacted: 67.7% had appointments cancelled, while 49.5% of those needing rehabilitation continued remotely.
Conclusions:
- Lockdown provided protection against infections for children with neurological disorders.
- Telemedicine and telerehabilitation were effective alternatives but not a definitive care model.
- Emergency response plans must prioritize the specific needs of children with disabilities.
Background:
The costs and benefits of full lockdown measures are debated. Neurologically impaired children are a vulnerable population with specific needs in terms of protection against infection and access to health services.
Objectives:
We investigated the effects of lockdown on the health of children with neurological disorders and on their access to care during lockdown.
Methods:
Data from 514 children (282 males - 232 females) were collected through physician-administered interviews to investigate: the occurrence of viral-like physical symptoms, the correlation between the risk of developing such symptoms and several demographic and clinical variables, the occurrence of any worsening of the children's neurological conditions during lockdown, and their access to care services during this period.
Results:
49.1% experienced at least one symptom during the study period, but no child developed severe complications. The prevalence of symptoms was significantly lower during lockdown than during the previous two months. The underlying neurological condition worsened in 11.5% of the patients. Children who regularly left the home during lockdown were greater risk of exhibiting symptoms. During lockdown, 67.7% had a specialist appointment cancelled, 52.6% contacted their paediatrician, and 30.9% contacted their child neuropsychiatrist. Among patients who usually receive rehabilitation, 49.5% continued remotely.
Conclusion:
Lockdown protected children from infections. Telemedicine and telerehabilitation constituted a valid alternative for the care and treatment of these children, but they should not become a widespread and definitive model of care. COVID-19 and other emergency response plans must take into account the specific needs of children with disabilities.
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