The suspected SARS-Cov-2 infection in a Charcot-Marie-Tooth patient undergoing postsurgical rehabilitation: the value of telerehabilitation for evaluation and continuing treatment

Prada, Valeria; Bellone, Emilia; Schenone, Angelo; Grandis, Marina

doi:10.1097/mrr.0000000000000418

Cited by 16 publications

(21 citation statements)

References 15 publications

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“…The characteristics of included trials were presented in Table 1 . A total of 269 patients from 47 studies [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] were included in our meta-analysis. The mean age of operative patients with COVID-19 was 50.91 [95% CI, 42.49; 59.34], and 49% [95% CI, 0.33, 0.65] patients were female.…”

Section: Resultsmentioning

confidence: 99%

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Wang¹,

Wu²,

Xu³

et al. 2020

EClinicalMedicine

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Background The 2019 novel coronavirus disease (COVID-19) can complicate the perioperative course to increase postoperative mortality in operative patients, and also is a serious threat to medical staff. However, studies summarizing the impact of COVID-19 on the perioperative mortality of patients and on the safety of medical staff are lacking. Methods We searched PubMed, Cochrane Library, Embase and Chinese database National Knowledge Infrastructure (CNKI) with the search terms “COVID-19″ or “SARS-CoV-2″ and “Surgery” or “Operation” for all published articles on COVID-19 from December 1, 2019 to October 5, 2020. Findings A total of 269 patients from 47 studies were included in our meta-analysis. The mean age of operative patients with COVID-19 was 50.91 years, and 49% were female. A total of 28 patients were deceased, with the overall mortality of 6%. All deceased patients had postoperative complications associated with operation or COVID-19, including respiratory failure, acute respiratory distress syndrome (ARDS), short of breath, dyspnea, fever, cough, fatigue or myalgia, cardiopulmonary system, shock/infection, acute kidney injury and severe lymphopenia. Patients who presented any or more of the symptoms of respiratory failure, ARDS, short of breath and dyspnea after operation were associated with significantly higher mortality ( r = 0.891, p < 0.001), while patients whose symptoms were presented as fever, cough, fatigue or myalgia only demonstrated marginally significant association with postoperative mortality ( r = 0.675, p = 0.023). Twenty studies reported the information of medical staff infection, and a total of 38 medical staff were infected, and medical staff who used biosafety level 3 (BSL-3) protective equipment did not get infected. Interpretation COVID-19 patients, in particular those with severe respiratory complications, may have high postoperative mortality. Medical staff in close contact with infected patients is suggested to take high level personal protective equipment (PPE). Funding Heilongjiang postdoctoral scientific research developmental fund and the National Natural Science Foundation of China.

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Section: Resultsmentioning

confidence: 99%

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Wang¹,

Wu²,

Xu³

et al. 2020

EClinicalMedicine

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“…https ://www. aan.com/sitea ssets /home-page/tools -and-resou rces/pract icing -neuro logis t--admin istra tors/telem edici ne-andre motecare/20-telem edici ne-and-covid 19-v103.pdf) [35] and reports of their rapid deployment are emerging [20,36]. The use of remote neurologic examination requires adaptation and inventiveness.…”

Section: Telehealth and Telerehabilitationmentioning

confidence: 99%

“…The nuances of deep tendon reflexes may be challenging via virtual approaches; however, a caregiver, if present, may be instructed to grossly evaluate briskly increased, reduced or asymmetric reflexes by tapping with fingers or objects [20]. A recent example of a neurologic examination at-distance comprises a suspected diagnosis of SARS-CoV-2 infection in a young patient with Charcot-Marie-Tooth polyneuropathy undergoing post-surgical telerehabilitation sessions [36]. Disease and non-disease-specific scales have been proposed for patients with NMD.…”

Section: Telehealth and Telerehabilitationmentioning

confidence: 99%

“…Professional societies are sharing guidelines on the correct implementation of telehealth approaches for neurological patients (e.g. https://www.aan.com/siteassets/home-page/tools-and-resources/practicing-neurologist--administrators/telemedicine-andremote-care/20-telemedicine-and-covid19-v103.pdf ) [ 35 ] and reports of their rapid deployment are emerging [ 20 , 36 ]. The use of remote neurologic examination requires adaptation and inventiveness.…”

Section: The Nmd Patient Without Sars-cov-2 Infectionmentioning

confidence: 99%

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Management of patients with neuromuscular disorders at the time of the SARS-CoV-2 pandemic

et al. 2020

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The novel Coronavirus disease-19 (COVID-19) pandemic has posed several challenges for neuromuscular disorder (NMD) patients. The risk of a severe course of SARS-CoV-2 infection is increased in all but the mildest forms of NMDs. High-risk conditions include reduced airway clearance due to oropharyngeal weakness and risk of worsening with fever, fasting or infection Isolation requirements may have an impact on treatment regimens administered in hospital settings, such as nusinersen, glucosidase alfa, intravenous immunoglobulin, and rituximab infusions. In addition, specific drugs for SARS-CoV2 infection under investigation impair neuromuscular function significantly; chloroquine and azithromycin are not recommended in myasthenia gravis without available ventilatory support and prolonged prone positioning may influence options for treatment. Other therapeutics may affect specific NMDs (metabolic, mitochondrial, myotonic diseases) and experimental approaches for Coronavirus disease 2019 may be offered "compassionately" only after consulting the patient's NMD specialist. In parallel, the reorganization of hospital and outpatient services may change the management of non-infected NMD patients and their caregivers, favouring at-distance approaches. However, the literature on the validation of telehealth in this subgroup of patients is scant. Thus, as the first wave of the pandemic is progressing, clinicians and researchers should address these crucial open issues to ensure adequate caring for NMD patients. This manuscript summarizes available evidence so far and provides guidance for both general neurologists and NMD specialists dealing with NMD patients in the time of COVID-19.

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“…Unfortunately, those who require rehabilitation are often made vulnerable by the disease (e.g., 90% of stroke clients in Switzerland are 65 and above) (2). Making matters worse, the pandemic resulted in very early inpatient discharge and a suspension of rehabilitation services in outpatient settings which decreased the access to rehabilitation services and their availability (3,4). As a result, occupational therapists were faced with providing interventions for an increasing number of clients isolated for their own protection or the protection of others.…”

Section: Introductionmentioning

confidence: 99%

Does Therapy Always Need Touch? - A cross-sectional study among Switzerland-based occupational therapists and midwives regarding their experience with health care at a distance during the COVID-19 pandemic in Spring 2020

Klamroth-Marganska

Gemperle

Ballmer

et al. 2020

Preprint

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Background: The COVID-19 pandemic impedes therapy and care activities. Health care at a distance (HCD) is a promising way to fill the supply gap. However, facilitators and barriers influence the use and experience of HCD in occupational therapists (OTs) and midwives.We identified use of services and appraisal of experiences of Switzerland-based OTs and midwives regarding the provision of HCD during the lockdown as it pertains to the COVID-19 pandemic in spring 2020. 1. Hypothesis: Profession, age in years, and area of work have a significant and meaningful influence over whether HCD is provided. 2. Hypothesis: Profession, age in years, area of work, possibility of reimbursement by health insurance, and application used have a significant and meaningful influence on the experience of HCD.Methods: In a cross-sectional survey, 5755 OTs and midwives were contacted to fill out an online questionnaire with 13 questions regarding demographic information, use of HCD and experiences while providing the service. Eleven potential facilitators and barriers and areas where there was desire for support were identified.Results: The questionnaire was completed by 1269 health professionals (response rate 22.5%). 73.4% of responding OTs (n=431) and midwives (n=501) provided HCD during the COVID-19 pandemic lockdown. Profession and area of work had a significant influence on whether HCD was provided. Age had only a significant influence on the use of videotelephony, SMS and chat services.OTs experienced HCD significantly more positively than midwives (log odds=1.3; p≤.01). Video-telephony (log odds=1.1; p≤.01) and use of phone (log odds=1.1; p=.01) were positive predictors for positive experience, while use of SMS (log odds=-0.33; p=.02) was a negative predictor. Among OTs, 75.7% experienced HCD as positive or mostly positive, while 13.9% experienced it as negative or mostly negative. Among midwives, 53.7% experienced it as positive or mostly positive, while 36.1% experienced it as negative or mostly negative. Most respondents desired support concerning reimbursement by health insurance (70.8%), followed by law and data protection (60.4%).Conclusions: HCD during the early COVID-19 pandemic was generally perceived as positive by OTs and midwives. There is need for training opportunities in connection with HCD during the COVID-19 pandemic.

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The suspected SARS-Cov-2 infection in a Charcot-Marie-Tooth patient undergoing postsurgical rehabilitation: the value of telerehabilitation for evaluation and continuing treatment

Cited by 16 publications

References 15 publications

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Management of patients with neuromuscular disorders at the time of the SARS-CoV-2 pandemic

Does Therapy Always Need Touch? - A cross-sectional study among Switzerland-based occupational therapists and midwives regarding their experience with health care at a distance during the COVID-19 pandemic in Spring 2020

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