Service polyhandicap adultes, Hôpital San Salvadour (Assistance Publique Hôpitaux de Paris), BP 30 080, 83407 Hyères cedex, France.
MD, Services de Neurologie et Rééducation Pédiatriques, Hôpital Necker Enfants Malades, APHP, 75015 Paris, France.
Arch Pediatr. 2021 Jul;28(5):374-380. doi: 10.1016/j.arcped.2021.04.004. Epub 2021 Apr 24.
Little is known about the clinical profile of COVID-19 infection in polyhandicapped persons. This study aimed to describe the characteristics of this infection among individuals with polyhandicap.
This was a retrospective observational study. Polyhandicap was defined by the combination of motor deficiency, profound mental retardation, and age at onset of cerebral lesion younger than 6 years. A positive COVID-19 status was considered for patients with a positive COVID-19 laboratory test result, or patients presenting with compatible symptoms and living in an institution or at home with other patients or relatives who had laboratory-confirmed COVID-19 infection. Data collection included sociodemographic data, clinical and paraclinical characteristics, as well as the management and treatment for COVID-19 infection.
We collected 98 cases, with a sex ratio of 0.98 and a mean age of 38.5 years (3 months to 73 years). COVID-19 infection was paucisymptomatic in 46% of patients, 20.6% of patients presented with dyspnea, while the most frequent extra-respiratory symptoms were digestive (26.5%) and neurological changes (24.5%); 18 patients required hospital admission, four adults died. The mean duration of infection was longer for adults than for children, and the proportion of taste and smell disorders was higher in older patients.
These findings suggest that PLH persons often develop paucisymptomatic forms of COVID-19 infection, although they may also experience severe outcomes, including death. Clinicians should be aware that COVID-19 symptoms in PLH persons are often extra-respiratory signs, mostly digestive and neurologic, which may help in the earlier identification of COVID-19 infection in this particular population of patients.
关于多发性残疾者 COVID-19 感染的临床特征知之甚少。本研究旨在描述多发性残疾者的感染特征。
这是一项回顾性观察研究。多发性残疾定义为运动功能障碍、深度智力障碍和脑损伤发病年龄小于 6 岁的组合。COVID-19 阳性状态被认为是指患者具有 COVID-19 实验室检测结果阳性,或具有符合 COVID-19 感染的症状并居住在机构或家中,与具有实验室确诊 COVID-19 感染的其他患者或亲属同住。数据收集包括社会人口学数据、临床和辅助检查特征,以及 COVID-19 感染的管理和治疗。
我们共收集了 98 例病例,男女比例为 0.98,平均年龄为 38.5 岁(3 个月至 73 岁)。46%的患者 COVID-19 感染症状轻微,20.6%的患者出现呼吸困难,最常见的呼吸道外症状为消化系统(26.5%)和神经系统变化(24.5%);18 例患者需要住院治疗,4 例成年人死亡。成人感染的平均持续时间长于儿童,且年长患者味觉和嗅觉障碍的比例更高。
这些发现表明,PLH 人群常发生 COVID-19 感染的症状轻微型,但也可能出现严重后果,包括死亡。临床医生应注意到,PLH 人群的 COVID-19 症状常为呼吸道外表现,主要为消化系统和神经系统症状,这有助于在该特殊患者群体中更早识别 COVID-19 感染。