Heat risk exacerbation potential for neurology patients during the COVID-19 pandemic and related isolation
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Heat risk exacerbation potential for neurology patients during the COVID-19 pandemic and related isolation Alex Buoite Stella 1 & Davide Filingeri 2 & Nicholas Ravanelli 3 & Shawnda A. Morrison 4 & Miloš Ajčević 1,5 & Giovanni Furlanis 1 & Paolo Manganotti 1 Received: 10 August 2020 / Revised: 9 October 2020 / Accepted: 29 October 2020 # ISB 2020
Abstract COVID-19 may increase the risk of heat-related symptoms during hot weather since vulnerable populations, including the elderly and those with neurological disabilities, must continue to self-isolate, often indoors. Within the chronic neurological patient population, indoor conditions in summer months present a hazard because of impaired and/or altered thermoregulation, including poor hydration status due to both autonomic and behavioral dysfunction(s). To address this increased risk, telemedicine protocols should include an assessment of the patient’s environmental parameters, and when combined with physiological data from wearable devices, identify those with neurological diseases who are at higher risk of heat illness. Personalized medicine during times of self-isolation must be encouraged, and using smart technology in ambient assisted living solutions, including e-health to monitor physiological parameters are highly recommended, not only during extreme weather conditions but also during times of increased isolation and vulnerability. Keywords COVID-19 . Neurological diseases . Physical distancing . Heat illness . Climate change . e-Health
Patients with neurological conditions are often at risk for suffering a variety of heat-related illnesses, especially when ambient temperatures are high. A recent World Meteorological Organization (WMO) and World Health Organization (WHO) promoted joint network (https://www.ghhin.org/ heat-and-covid-19) has determined that the indirect effect of extreme heat events will exacerbate patients’ underlying conditions, especially considering the context of physical distancing and self-isolation measures imposed because of the ongoing COVID-19 pandemic. Indeed, isolation and
* Alex Buoite Stella [email protected] 1
Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy
2
THERMOSENSELAB, Environmental Ergonomics Research Centre, Loughborough University, Loughborough, UK
3
School of Kinesiology, Lakehead University, Thunder Bay, Canada
4
Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
5
Department of Engineering and Architecture, University of Trieste, Via Alfonso Valerio, 10, 34127 Trieste, Italy
dependency are key factors associated with a higher risk of suffering heat-related illnesses during heatwaves (Belmin et al. 2007). Current directives to prevent the spread of COVID-19 may further restrict access to cooling spaces and/ or limit the use of air conditioning in public areas. A recent WHO technical report suggests that the most vulnerable populatio
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