Why individuals with cerebral palsy are at higher risk for respiratory complications from COVID-19

Abstract

Respiratory dysfunction is a leading cause of morbidity and mortality in individuals with cerebral palsy (CP). In children and adults with CP, movement and physical function is always affected. Yet, many clinicians overlook potential for impaired movement and function of the diaphragm muscle (DIAm) in individuals with CP. Since individuals with pre-existing respiratory disorders are at greater risk for respiratory complications if they contract COVID-19, understanding potential risks to individuals with CP is important. In this review we present research on respiratory function and DIAm force generation in children with CP. We compare this clinical work to basic science research investigating phrenic motor neuron and DIAm motor unit dysfunction in an animal model with CP symptoms, the spa mouse. Finally, we integrate the clinical and basic science work in respiratory function in CP, discussing potential for individuals with CP to have severe respiratory symptoms from COVID-19.

The impact of COVID-19 on the lifestyles of adolescents with cerebral palsy in the Southeast United States

“…Contracting COVID-19 is generally concerning among people with cerebral palsy, because respiratory illness is a leading cause of morbidity and mortality in this population. 32 Instead of declines in physical health, study findings suggested that mental health and healthy behaviors, including in-person socialization, community activity (e.g., going to grocery stores instead of ordering food), and exercise were key lifestyle factors that were altered by COVID-19.…”

“…The sample consisted of primarily young adolescents ( M age = 14 ± 2 yrs) and the sex and ethnicity representations were similar to U.S. Census Bureau demographic estimates in the state of Alabama. 32 The sample also consisted of people with a diverse mixture of GMFCS levels and household incomes. GLTEQ scores indicated that the sample included a roughly equivalent mixture of physically active and inactive adolescents, but the sample was generally classified as physically inactive.…”

Risk factors for severe COVID-19 infection in Brazilian children

“…Respiratory dysfunction is a leading cause of morbidity and mortality in individuals with neurological chronic disorder since these patients have impairments in respiratory function, such as a decreased respiratory capacity or a weak cough. 20 Therefore, understanding the underlying pathophysiologic association between neurological disorder and SARS-CoV-2 infection is important to identify possible clinical interventions and preventive strategies to reduce the risk for hospitalization.…”

Education on Nutrition and Seizure Control in Children with Cerebral Palsy for “Mitra Ananda” Community Organization in Gunungkidul, Yogyakarta, Indonesia

“…In addition, we know that advanced age and pre-existing respiratory comorbidities are significant risk factors for respiratory complications from Covid-19. So, if a person with CP catches Covid-19 and develops respiratory symptoms, they should be informed that they could be at a higher risk of developing severe respiratory symptoms (Brandenburg et al, 2020).…”