Changes in Healthcare Provision During Covid-19 and Their Impact on Children With Chronic Illness: A Scoping Review

Abstract

This paper provides an overview of the evidence around how the health systems and policy response to the Covid-19 pandemic affected children with long-term conditions in the UK. We conducted a scoping review guided by the PRISMA-ScR Checklist. The PubMed and PsycINFO databases (2019-August 2021) were searched and screened for papers (of any design) by 2 reviewers independently. The electronic database search was supplemented by manual searching. A total of 32 papers were identified, including studies on UK paediatric populations, studies on chronic illness in the UK, and international studies on chronic illness and children (including data from the UK). Most studies focussed on epilepsy, cancer, diabetes or asthma. Three categories of impact were identified: ( a) impact of policy response on the delivery of and access to child healthcare ( b) impact of innovative practice on children’s physical and mental health ( c) impact of service restrictions on children’s physical health. Our results showed that policy response to the pandemic significantly affected healthcare provision for children with chronic illness in the UK. However, the specific assessment of the impact of service restrictions and innovative practice on children’s health and wellbeing is limited. Future research is required to fill knowledge gaps on changes in access to effective diagnostic and treatment investigations and their impact on a range of paediatric patients during the pandemic.

Changes in cancer prevention and management and patient needs during the COVID-19 pandemic: An umbrella review of systematic reviews

“…Specific recommendations established from the guidelines such as prioritization of high-grade malignancy, as well as other aspects such as lockdowns, social restrictions, restructure of cancer care with prioritization of high-risk malignancies and use of telemedicine, fear of infection, financial distress and shortage in medications could explain the delays and cancellation in cancer treatment, screening and diagnosis reported in several studies. For example, Lignou S et al 202 38 raised concerns that use of telehealth for people with cancer suggests a greater proportion of missed diagnoses. Most of examined systematic reviews reported a substantial reduction in treatment, screening, and diagnosis of several cancers during the pandemic, which was more pronounced for countries that implemented a lockdown.…”

“…Lignou S et al 2022 38 reported that between 18 th to 31 st of January 2021, pediatric and noncancer surgical activities were occurring at less than a third of the rate of the previous year, while Di Cosimo SD et al 2022 34 reported cancellation/delays of treatment in 58% (95%CI, 48%-67%; I 2 , 98%) of centers. Majeed A et al, 2022 14 showed that shortage of treatment and delays and interruptions to cancer therapies in general were more common in low-and middle-income countries.…”

“…While little research exists on how patients perceived telemedicine during the COVID-19 pandemic, early data showed that majority of patients found telemedicine service helpful and that obtaining a telemedicine service helped solve their health problem. Nevertheless, there were concerns that use of telehealth for people with cancer suggests a greater proportion of missed diagnoses 38 , and that telemedicine cannot be a substitute for face-to-face appointments 25 .…”

Children with medical complexities: their distinct vulnerability in health systems’ Covid-19 response and their claims of justice in the recovery phase

“…To enable children with chronic illness to escape from corrosive vulnerability in the aftermath of the pandemic and the different kinds of harm that would result from it, factors that create and sustain vulnerabilities and harm need to be critically evaluated and addressed. This suggests that different types of evidence are important (Lignou et al 2022 ) to inform policies in addressing the longer-term impact of Covid-19 on child health and plans for future pandemics, and for identifying strategies that can eliminate systemic weaknesses in meeting the complex needs of children with chronic conditions more generally.…”

Parental anxiety/incompliance and patients’ complications during COVID-19 pandemic regarding nasoalveolar molding treatment of infants with cleft lip/palate

“… 2 Redirection of medical and human resources to providing pandemic services and the importance of protecting the patients and health workers led to the suspension of unurgent treatments. 3 , 4 …”