Children and adolescents with disabilities in Brazil: effects of the COVID-19 pandemic

Abstract

The present research aimed to perform data survey and analysis of children and teenagers among 0- to 19-year-olds related to SARS (severe acute respiratory syndrome) and COVID-19 in populations with or without disabilities during the year of 2020. The database used for the evaluations was Sivep-Gripe, made available by the Ministry of Health. The database did not present variables regarding the type of disability and a proxy was created by the binary variable of Down syndrome and by qualitative analysis of clinical data of descriptive morbidity. This limitation hindered the consideration of the experience of disability as an interaction between bodily impairments and the environment, as well as the generalization regarding cases in this population. The analysis variables included individual, regional and progression characteristics of the cases, such as the need for hospitalization, admission to the ICU, use of ventilatory supports and evolution of the cases for the recovery or death. 83,491 cases of children up to 19 years old were considered. Of this total, 2,370 (3.27%) were categorized with the disability proxy. The analyzes showed the differences between cases and progressions between children and young people without disabilities and by type of disability, with the highest proportions of COVID-19 cases found in those with physical, intellectual or psychosocial disabilities. Considering the age groups, we found higher frequencies of these cases among children up to 4 years old in general; with intellectual or psychosocial disabilities between 5 and 9 years; and those with physical disabilities between 14 and 19 years. The progression of the children's cases demonstrates the relevance of considering their vulnerability and its effects on hospital establishments, since they are more susceptible to being hospitalized, requiring ICU admissions and respiratory support. Even with the use of these resources for the maintenance of life, the proportion of children with disabilities who evolve to death is equivalent to more than double (in the cases of COVID-19) and triple (SARS) of those without disabilities. Based on these verifications, we emphasize the need to further investigate, plan and execute public policies that target this population, especially in relation to health services in the current context of increasing cases of COVID-19 and its variants across the country. In addition, we seek to contribute to academic discussions that address disability as a relevant social marker that permeates the different layers of inequality and social exclusion, exposed and deepened in the pandemic context.