Ahmed K Bamaga1,2, Fouad Alghamdi3, Nahla Alshaikh4,5,6, Waleed Altwaijri7,8, Fahad A Bashiri9,10, Khalid Hundallah11, Musaad Abukhaled12, Osama Y Muthaffar1,2, Sameer Al-Mehmadi13, Tahani Ahmed Jamaly14, Mohammad A Al-Muhaizea11, Abdulaziz Al-Saman15. 1. Neurology Division, Pediatric Department, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia. 2. Pediatric Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia. 3. King Fahad Specialist Hospital, Dammam, Saudi Arabia. 4. Pediatric Department, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia. 5. College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia. 6. King Abdullah International Medical Research Center, Jeddah, Saudi Arabia. 7. Pediatric Department, King Saud Bin Abdulaziz University, Riyadh, Saudi Arabia. 8. Pediatric Department, King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia. 9. Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia. 10. Division of Neurology, Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia. 11. Prince Sultan Military Medical City, Riyadh, Saudi Arabia. 12. Department of Neuroscience, King Faisal Specialist Hospital and Research Centre, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. 13. Department of Pediatric Neurology, Children's Hospital, King Saud Medical City, Riyadh, Saudi Arabia. 14. Children Health Center, International Medical Center, Jeddah, Saudi Arabia. 15. Pediatric Neurology Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia.
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has caused overwhelming challenges in healthcare worldwide. During such an outbreak, some needs of high-risk groups who require regular follow-ups and long-term management are not met. The vulnerable populations include patients with Duchenne muscular dystrophy (DMD). Duchenne muscular dystrophy is characterized by respiratory complications caused by muscle weakness. Hence, patients with this condition are at high risk of severe diseases including COVID-19. Methods: To standardize care and provide optimal treatment to DMD patients in Saudi Arabia during the COVID-19 pandemic, a panel of experts including neurologists and pediatricians consolidated recommendations for healthcare professionals and caregivers. Results: During this pandemic, substituting unnecessary clinic visits with virtual clinic services was highly recommended, if possible, without compromising clinical outcomes. Duchenne muscular dystrophy patients with respiratory complications should be closely monitored, and those with cardiovascular complications must continue taking angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Moreover, individualized home-based rehabilitation management was preferred. Glucocorticoid and new gene correction therapies should be continued. However, new gene correction therapy must be post-poned in newly diagnosed patients. A multidisciplinary decision was required before the initiation of hydroxychloroquine based on the COVID-19 treatment protocol. Conclusion: COVID-19 has caused challenges and transformed access to health care. However, these limitations have provided opportunities for the health care system to adapt. Further, telemedicine has become a reliable platform for follow-up appointments that should be conducted by a multidisciplinary team including physicians, dieticians, and physical therapists.
Background: The coronavirus disease 2019 (COVID-19) pandemic has caused overwhelming challenges in healthcare worldwide. During such an outbreak, some needs of high-risk groups who require regular follow-ups and long-term management are not met. The vulnerable populations include patients with Duchenne muscular dystrophy (DMD). Duchenne muscular dystrophy is characterized by respiratory complications caused by muscle weakness. Hence, patients with this condition are at high risk of severe diseases including COVID-19. Methods: To standardize care and provide optimal treatment to DMDpatients in Saudi Arabia during the COVID-19 pandemic, a panel of experts including neurologists and pediatricians consolidated recommendations for healthcare professionals and caregivers. Results: During this pandemic, substituting unnecessary clinic visits with virtual clinic services was highly recommended, if possible, without compromising clinical outcomes. Duchenne muscular dystrophypatients with respiratory complications should be closely monitored, and those with cardiovascular complications must continue taking angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Moreover, individualized home-based rehabilitation management was preferred. Glucocorticoid and new gene correction therapies should be continued. However, new gene correction therapy must be post-poned in newly diagnosed patients. A multidisciplinary decision was required before the initiation of hydroxychloroquine based on the COVID-19 treatment protocol. Conclusion:COVID-19 has caused challenges and transformed access to health care. However, these limitations have provided opportunities for the health care system to adapt. Further, telemedicine has become a reliable platform for follow-up appointments that should be conducted by a multidisciplinary team including physicians, dieticians, and physical therapists.
Authors: Eliza Wasilewska; Agnieszka Sobierajska-Rek; Karolina Śledzińska; Sylwia Małgorzewicz; Ewa Jassem; Jolanta Wierzba Journal: Int J Environ Res Public Health Date: 2021-12-30 Impact factor: 3.390