A Pediatric Emergency Department Protocol to Avoid Intrahospital Spread of SARS-CoV-2 during the Outbreak in Bergamo, Italy

Nicastro, Emanuele; Mazza, Angelo; Gervasoni, Annalisa; Giorgio, Angelo Di; D’Antiga, Lorenzo

doi:10.1016/j.jpeds.2020.04.026

Cited by 23 publications

(23 citation statements)

References 5 publications

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“…Notwithstanding, minor febrile and respiratory diseases in our own experience were more frequently assessed in ED during the COVID-19 epidemic, possibly suggesting parental anxiety about this disease, primary-care reluctance to evaluate these children due to lack of personal protective equipment, and well-established hospital COVID-19 pathways within EDs (21,22).…”

Section: Discussionmentioning

confidence: 80%

Effect of Population Lockdown on Pediatric Emergency Room Demands in the Era of COVID-19

et al. 2020

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The aim of this study was to assess the impact of the COVID-19 pandemic and population lockdown on pediatric ED consultations. Methods: A cross-sectional study on pediatric emergency department consultations before and during the current COVID-19 pandemic (March-May 2019 vs. March-May 2020) was performed in two hospitals in the Campania region (Southern Italy) [i.e., Salerno University Hospital (Salerno) and Pediatric Regional Referral Emergency Hub "AORN Santobono-Pausillipon" (Naples)]. Results: 29,368 consecutive ED pediatric patients (13,430 females; mean age ± SD = 5.4 ± 4.7 years) were seen in March-May 2019 and 9,133 (4,494 females; mean age ± SD = 5.9 ± 4.2 years) in March-May 2020. Resuscitation/emergency and urgent care pediatric ED consultations were 1,388 (4.7%, 95% CI 4.5-4.9) in the 2019 trimester, while they were 648 (7.1%, 95% CI 6.6-7.6) in the 2020 trimester (p < 0.01). Mean pediatric ED daily consultations were 326.3 (95% CI 299.9-352.7) in the considered period of 2019 and 101.4 (95%CI 77.9-124.9) in the same period of 2020 (p < 0.001). COVID-19 nasal swabs were performed for 385 children; of those, six resulted positive and four of them were hospitalized. Conclusions: This work provides a unique snapshot of the pediatric EDs demands in the era of COVID-19. We witnessed a significant reduction of non-urgent health care demands during the pandemic but an increase of more severe urgent cases. The COVID-19 pandemic and the following lockdown unveiled the inappropriateness of the majority of pediatric ED consultations. Nevertheless, the current scenario highlighted the need for appropriate and timely clinical evaluations in the pediatric primary care to tackle late and more severe diagnoses in EDs.

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Section: Discussionmentioning

confidence: 80%

Effect of Population Lockdown on Pediatric Emergency Room Demands in the Era of COVID-19

et al. 2020

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“…This may be explained by the fact that most of our outpatient activities were cancelled or markedly reduced; therefore, many minor procedures and non-urgent medical consultations took place in the pediatric ED and were classified as white codes. A proper reorganization of the pediatric services became necessary during the first wave of COVID-19 pandemic: national and local protocols were developed according to the WHO guidelines to provide dedicated pathways for suspected COVID-19 cases and guarantee appropriate healthcare to other patients [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of COVID-19 on a tertiary care pediatric emergency department

et al. 2021

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“…Despite being the epicenter of the pandemic at the beginning, the Italian centers had not reported confirmed symptomatic cases at the time of the survey. Recently, NiCastro et al 30 informed about the adoption of protocols for the early detection of cases in the pediatric population attended in pediatric hospital in Bergamo. During this study, there were no admitted patients who tested positive for SARS‐CoV‐2 from the pediatric transplant unit.…”

Section: Discussionmentioning

confidence: 99%

Pediatric transplantation in Europe during the COVID‐19 pandemic: Early impact on activity and healthcare

Donà

Canizales

Benetti

et al. 2020

Clinical Transplantation

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The current pandemic SARS‐CoV‐2 has required an unusual allocation of resources that can negatively impact chronically ill patients and high‐complexity procedures. Across the European Reference Network on Pediatric Transplantation (ERN TransplantChild), we conducted a survey to investigate the impact of the COVID‐19 outbreak on pediatric transplant activity and healthcare practices in both solid organ transplantation (SOT) and hematopoietic stem cell transplantation (HSCT). The replies of 30 professionals from 18 centers in Europe were collected. Twelve of 18 centers (67%) showed a reduction in their usual transplant activity. Additionally, outpatient visits have been modified and restricted to selected ones, and the use of telemedicine tools has increased. Additionally, a total of 14 COVID‐19 pediatric transplanted patients were identified at the time of the survey, including eight transplant recipients and six candidates for transplantation. Only two moderate‐severe cases were reported, both in HSCT setting. These survey results demonstrate the limitations in healthcare resources for pediatric transplantation patients during early stages of this pandemic. COVID‐19 disease is a major worldwide challenge for the field of pediatric transplantation, where there will be a need for systematic data collection, encouraging regular discussions to address the long‐term consequences for pediatric transplantation candidates, recipients, and their families.

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A Pediatric Emergency Department Protocol to Avoid Intrahospital Spread of SARS-CoV-2 during the Outbreak in Bergamo, Italy

Cited by 23 publications

References 5 publications

Effect of Population Lockdown on Pediatric Emergency Room Demands in the Era of COVID-19

Effect of Population Lockdown on Pediatric Emergency Room Demands in the Era of COVID-19

The impact of COVID-19 on a tertiary care pediatric emergency department

Pediatric transplantation in Europe during the COVID‐19 pandemic: Early impact on activity and healthcare

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