Impact of COVID-19 lockdown in children with neurological disorders in Italy.
Stefania Maria Bova, Martina Basso, Marta Francesca Bianchi and 6 others
PMID 33358228WHAT IT FOUND
Lockdown was linked to fewer viral-like symptoms in 514 children with neurological disorders in Italy: risk was about 80% lower than before lockdown.
Yet 67.7% had specialist visits cancelled and 90.6% of children who usually received rehabilitation lost face-to-face sessions.
Key findings
01During lockdown, the risk of developing at least one viral-like symptom was around 80% lower than before lockdown (OR = 0.22; 95% CI 0.16 to 0.30).
02Care access was disrupted: 348 children had specialist appointments cancelled, and 269 of the 297 children who usually received rehabilitation had face-to-face sessions cancelled.
03No child had a confirmed SARS-CoV-2 diagnosis, and during lockdown 51 children had neurological worsening with viral-like symptoms while 8 had worsening unrelated to symptoms.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
SARS-CoV-2 testing could not be done in the whole sample, so viral-like symptoms could not be confirmed as infection. Only 28 children had swab tests, and all were negative, so the study cannot show whether COVID-19 was absent. The risk-factor analysis used very small numbers of symptomatic children, giving wide confidence intervals that could not be interpreted with certainty. Many eligible children were not analysed: 55 could not be reached, 67 had language barriers, 10 left the country, and 14 caregivers did not consent. Symptoms were reported by caregivers in phone interviews, not measured clinically. The study was retrospective and observational, so it cannot prove that lockdown caused the lower symptom risk.
Declared interests
The study received no specific funding. The authors declared no competing interests. Dr Veggiotti reported educational grants from EISAI, Nutricia, Dr Schar, and Pediatrica outside the submitted work.
The easy way to misread this
Do not read the 80% lower symptom risk as proof that lockdown was good overall or that telerehabilitation worked. The same lockdown period had 348 cancelled specialist appointments and 269 cancelled face-to-face rehabilitation sessions.