COVID-19’s Impact on Children With Disabilities and Caregivers

Early data reported a disproportionate impact of death rates and infection rates in Black, Native American, and Latinx communities.

In a recent special issue of the Journal of Pediatric Rehabilitation Medicine, experts assessed how the coronavirus disease 2019 (COVID-19) pandemic has affected the pediatric patients with special needs population, as well as their caregivers and healthcare providers, while also commenting on the evolving role of telemedicine and its growing importance for the future.

Most of the attention has been given to older populations due to the disproportionate impact COVID-19 has had on them. Children only comprise 2% of those infected with the virus and in most cases, they are asymptomatic or only have mild symptoms. However, children with certain disabilities like cerebral palsy (CP) are at a higher risk and are more vulnerable for respiratory complications. In certain instances, they can present with multisystem inflammatory syndrome (MIS-C), in which case they would require supportive care.

The special issue addressed a variety of aspects dealing with the disease in vulnerable pediatric populations, including spasticity management, autism spectrum disorders, CP, neuromuscular disorders, tracheostomies, MIS-C, schooling, and how to deliver medicines safely and effectively. After reviewing research on respiratory function and diaphragm muscle force generation in patients with pre-existing respiratory disorders like CP, the investigators determined that they are more likely to develop complications if they contract the virus.

"We need to be vigilant in encouraging and supporting families of children with CP and individuals who have CP to practice physical distancing, good hand hygiene, minimizing trips to public places such as stores and restaurants, and thorough cleaning of any equipment that is used outside the home (i.e., walkers and wheelchairs) in order to reduce the risk of contracting COVID-19,” Joline E. Brandenburg, a physician in the Department of Physical Medicine and Rehabilitation, and Department of Pediatric and Adolescent Medicine at the Mayo Clinic said.

Also analyzed was the rise in telemedicine since the beginning of the COVID-19 pandemic. In a survey of pediatric physiatrists conducted by investigators from Marianjoy Rehabilitation Hospital, they found that the utilization of telehealth went from less than 15% to 90%, with 77% feeling confident in the quality of the care they provided.

"Through this issue of the Journal of Pediatric Rehabilitation Medicine we are disseminating a wealth of information on COVID-19 and the effect that it has on our pediatric rehabilitation caregivers, providers and those with special needs," Elaine L. Pico, Editor-in-Chief of the journal said. "It is my belief that this type of worldwide outreach and exchange of information is an essential part of the global solution to help mitigate the spread of this deadly virus.”