Impact of SARS-CoV-2 pandemic on the care for patients with lysosomal disorders: The experience of a Mexican pediatric center

On March 30th, 2020, the Mexican Government declared a Sanitary Emergency in order to control the effects of SARS-CoV-2 pandemic. We present our experience on the impact of SARS-CoV-2 pandemic in a Mexican pediatric center of Lysosomal diseases. A total of 20 patients are receiving enzyme replacement therapy (ERT) in our center, 13 males (65%) and 7 females (35%). Patients distribution by disease consisted: (4) Fabry, (6) Gaucher, (5) mucopolysaccharidosis type I, (2) mucopolysaccharidosis type II, (2) mucopolysaccharidosis type IV and (1) Pompe. At the beginning of the emergency, from March 18th to March 27th infusions were suspended restarting on April 15th. Subsequently, the interruption or modification of the use of medical resources, including ERT and medical consults, varied depending on the redistribution of hospital resources, geographic living area, the presence of symptoms compatible with SARS-CoV-2, mobility limitations, shortage of recombinant enzymes and personal issues.In total, 70 infusions were missed, mean 3–4 infusions per patient. For the hospital infusions we implemented some strategies to avoid nosocomial SARS-CoV-2 infection: a) A temperature filter. B) A questionnaire about symptoms. C) Personal protective equipment. D) An active and timely performance of tests. E) Social distancing with 2 m of distance between patients. No proved infection by SARS-CoV-2 virus was recorded, four patients presented respiratory symptoms, five SARS-COV2 PCR nasopharyngeal swab were negative, in one patient the test was not available. The consequences of the pandemic are both direct and indirect, secondary to the forced reorganization of the healthcare system. In our experience the pandemic affected the ERT hospital infusions, however, we did not have any child with confirmed SARS-CoV-2 infection, none of the patients required hospitalization due to decompensation and we continued the infusion program successfully.