Child Neurology Unit, Vittore Buzzi Children's Hospital, Università di Milano, via Castelvetro 32, 20154, Milano, Italy.
National Centre for Healthcare Research & Pharmacoepidemiology, Università di Milano-Bicocca Milan, Via Bicocca degli Arcimboldi, 8, 20126, Italy; Laboratory of Healthcare Research & Pharmacoepidemiology, Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, Università di Milano-Bicocca Milan, Via Bicocca degli Arcimboldi, 8, 20126, Italy.
Disabil Health J. 2021 Apr;14(2):101053. doi: 10.1016/j.dhjo.2020.101053. Epub 2020 Dec 16.
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.
We investigated the effects of lockdown on the health of children with neurological disorders and on their access to care during lockdown.
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.
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.
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.
全面封锁措施的成本和收益存在争议。神经发育障碍儿童是一个弱势群体，在预防感染和获得卫生服务方面有特殊需求。
我们调查了封锁对神经发育障碍儿童健康的影响，以及他们在封锁期间获得护理的情况。
通过医生进行的访谈收集了 514 名儿童（282 名男性-232 名女性）的数据，以调查：是否出现类似病毒的身体症状；出现这些症状的风险与几个人口统计学和临床变量的相关性；在封锁期间儿童的神经状况是否有任何恶化；以及在此期间他们获得护理服务的情况。
49.1%的儿童在研究期间至少出现了一种症状，但没有儿童出现严重并发症。在封锁期间，症状的发生率明显低于前两个月。11.5%的患者神经状况恶化。在封锁期间经常离开家的儿童出现症状的风险更大。在封锁期间，67.7%的儿童取消了专科预约，52.6%的儿童联系了儿科医生，30.9%的儿童联系了儿童神经精神科医生。在通常接受康复治疗的患者中，49.5%的人远程接受治疗。
封锁使儿童免受感染。远程医疗和远程康复是这些儿童护理和治疗的有效替代方法，但不应成为广泛和确定的护理模式。COVID-19 和其他应急计划必须考虑到残疾儿童的特殊需求。
