Breathing problems and COVID-19 in patients with developmental disabilities
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Universidade Federal de Minas Gerais
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Resumo
Poor access to health care can be detrimental to pediatrichealth, and children with special needs are potentially athigher risk for severe diseases. Accordingly, developingcountries such as Brazil are suffering even more withthe SARS-CoV-2 outbreak. The epidemy has exponen-tially advanced overall the country. The official numbersare underestimated, challenging any further politics toprevent virus dissemination, that is, contingency plansand scientific studies. In the dental community, doubtsabout the outbreak have led to an array of professionalconcerns in terms of patient care provisions and safetymeasures. Until June 2020, there is no vaccine availablefor COVID-19, although several research groups have for-mulations in the testing phase. By now, a consensus aboutthe guidelines applicable for special care management inthe dental clinical setting remains unclear.We hypothesize that the prevalence of preexistingbreathing problems in the population with developmen-tal disabilities may serve as a predictor of possible com-plications in cases of infection with the new coronavirus.From our point of view, the implementation of new andstricter biosafety protocols is needed. The dental team,patients, and caregivers need to be constantly aware ofthe appearance of common COVID-19 symptoms, beginself-isolation, and avoid virus dissemination. Moreover,it is also possible to consider implementing preadmis-sion or preprocedure testing for COVID-19, depending ontesting availability and how rapidly the results are deliv-ered. Despite that, there are limitations on this approach,like negative results from patients or professionals duringthe SARS-CoV-2 incubation period, who could become atransmission source later after testing. Moreover, individ-uals can be exposed or contribute to cross-contaminationeven by taking public transportation or while going to thesupermarket. Accordingly, the gap between the moment of testing until the results are delivered or the patient isadmitted will always be an uncovered risky period.We believe that minimize elective treatments as far aspossible are essential to reduce the exposure risk of specialcare patients while the pandemic exists. Otherwise, if nec-essary, elective treatments should be performed preferablyin individuals who do not have any preexisting respiratoryconditions. A second precaution, when available, would bethe IgG and IgM anti-SARS-CoV-2 serology, even thoughit is still unknown whether these patients are immune andfor how long. Finally, the dental team should be preparedfor dental emergent/urgent situations, and remote supportshould always be offered to patients and caregivers when-ever requested.
Abstract
Assunto
Respiratory tract diseases, COVID-19, Disabled persons, Dental care
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Breathing problems, COVID-19, Developmental disabilities
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https://onlinelibrary.wiley.com/doi/10.1111/scd.12504