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10.3233/PRM-200756

http://scihub22266oqcxt.onion/10.3233/PRM-200756
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33252098!ä!33252098

suck abstract from ncbi


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pmid33252098      J+Pediatr+Rehabil+Med 2020 ; 13 (3): 273-279
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  • A risk-stratified approach toward safely resuming OnabotulinumtoxinA injections based on dosing and ambulatory status in pediatric patients with cerebral palsy during the Coronavirus pandemic of 2019 (COVID-19) #MMPMID33252098
  • McLaughlin MJ; Fisher MT; Vadivelu S; Ramsey J; Ratnasingam D; McGhee E; Hartman K
  • J Pediatr Rehabil Med 2020[]; 13 (3): 273-279 PMID33252098show ga
  • PURPOSE: After the onset of the Coronavirus pandemic of 2019-2020 (COVID-19), physicians who inject OnabotulinumtoxinA (BoNT-A) were left with determining risks and benefits in pediatric patients with cerebral palsy. Many of these patients have pre-existing conditions that make them more prone to COVID-19 symptoms, and this susceptibility potentially increases after BoNT-A injections. METHODS: A retrospective chart review of 500 patients identified 256 pediatric patients with cerebral palsy who received an intramuscular BoNT-A injection to determine relative doses used for each Gross Motor Functional Classification Score (GMFCS). Data regarding age, weight, GMFCS, BoNT-A total body dosage, and inpatient hospitalizations for 6 months post-injection were collected. Differences between GMFCS levels were analyzed using one-way analysis of variance testing. Inpatient hospitalizations were recorded and assessed using relative risk to determine the population risk of hospitalization in the setting of initiating injections during the COVID-19 pandemic. RESULTS: Based on GMFCS level, patients who were GMFCS I or II received fewer units of BoNT-A medication per kilogram of body weight compared to GMFCS III-V (p< 0.0005, F= 25.38). There was no statistically significant difference in frequency or time to hospitalization when comparing patients receiving BoNT-A compared to a control group. CONCLUSIONS: Resumption of BoNT-A injections during the time of COVID-19 requires a systematic approach based on risks and potential benefits. Data from this analysis does not show increased risk for patients who received injections historically; however, recommendations for resumption of injections has not previously been proposed in the setting of a pandemic. In this manuscript, a tiered approach to considerations for injections was proposed. Botulinum toxin type A injections have a history of improving spasticity in the pediatric patient with cerebral palsy. Ensuring appropriate selection of patients for injection with BoNT-A during this pandemic is increasingly important.
  • |*Pandemics[MESH]
  • |Botulinum Toxins, Type A/*administration & dosage[MESH]
  • |COVID-19/*epidemiology/prevention & control/transmission[MESH]
  • |Case-Control Studies[MESH]
  • |Cerebral Palsy/*drug therapy[MESH]
  • |Child[MESH]
  • |Dose-Response Relationship, Drug[MESH]
  • |Drug Administration Schedule[MESH]
  • |Humans[MESH]
  • |Infectious Disease Transmission, Patient-to-Professional/prevention & control[MESH]
  • |Injections, Intramuscular[MESH]
  • |Neuromuscular Agents/*administration & dosage[MESH]
  • |Patient Selection[MESH]
  • |Personal Protective Equipment[MESH]
  • |Retrospective Studies[MESH]
  • |United States/epidemiology[MESH]


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