Children or adults who had hemispherectomy surgery are not at higher risk of getting COVID-19.
Generally, hemispherectomy surgery should not increase the severity of COVID-19; however, children and adults who also have cognitive challenges may be at higher risk. Here’s why:
Children or adults with hemiparesis, which occurs after hemispherectomy surgery (and sometimes before), may have weakened respiratory muscles – the diaphragm and the intercostal muscles that are in between the ribs. In everyday life, this is not a noticeable problem because normal breathing requires very little effort. Even a person with muscle weakness can breathe normally.
If the lungs become infected, such as in cases of severe pneumonia or severe COVID-19, taking deep breaths helps move around the mucus in the lungs and clear the windpipes. A person with weak respiratory muscles due to hemiparesis may have to work harder to take deep breaths. If a child or adult also has cognitive challenges, he/she may not understand how to intentionally take deep breaths on command. This may increase the likelihood of severe symptoms of COVID-19.
Also, children or adults with cognitive challenges may not be able to generate a strong cough on command. This may cause them to have to retain mucus that may clog up the windpipes in the lungs.
Children or adults who have developed swallowing problems before or after surgery will be more prone to choking and aspirating during a severe or intense illness. All these factors can complicate even minor infections and would complicate symptoms of COVID-19.
There is some silver lining here: doctors in other countries affected by COVID-19 report that children, including those with serious underlying health problems, have been affected significantly less (both in numbers and severity) than older healthy adults. Using the precautions recommended for everybody (such as frequent hand-washing, avoiding close contact, etc.) this trend will hopefully continue.
Our profound gratitude to Dr. Anastassios C. Koubourlis, M.D., M.P.H., Chief, Division of Pulmonary & Sleep Medicine and Director of the Cystic Fibrosis Center at Children’s National Medical Center for assisting with this content.