Restructuring of a pediatric hospital in the face of the COVID-19 pandemic

Villa-Guillén, Mónica; Garduño-Espinosa, Juan; Herrera-Segura, Miriam G; Moreno-Espinoza, Sarbelio; Rosa-Zamboni, Daniela de la; López-Martı́nez, Briceida; Rosales-Uribe, Rómulo Erick; Sienra-Monge, Juan José Luis; Cerón‐Rodríguez, Magdalena; Olivar-López, Víctor; Chávez-López, Adrián; Álvarez-Soberanis, Enid; Jiménez-Juárez, Rodolfo Norberto; Miranda-Lora, América Liliana; Nieto-Zermeño, Jaime

doi:10.24875/bmhim.20000265

Cited by 5 publications

(4 citation statements)

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“…The study was done at a Pediatric Tertiary Level Referral Hospital restructured to receive COVID patients in Mexico City between April 2020 and December 2021 (6). Newborns with a positive real time polymerase chain reaction (RT-PCR) for the SARS-CoV-2 virus by nasal swab irrespective of the working diagnosis were included.…”

Section: Methodsmentioning

confidence: 99%

Lung Ultrasound Characteristics in Neonates With Positive Real Time Polymerase Chain Reaction for SARS-CoV-2 on a Tertiary Level Referral Hospital in Mexico City

et al. 2022

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IntroductionAcute respiratory syndrome secondary to SARS-CoV-2 virus infection has been declared a pandemic since December 2019. On neonates, severe presentations are infrequent but possible. Lung ultrasound (LUS) has been shown to be useful in diagnosing lung involvement and following up patients, giving more information, and reducing exposure compared to traditional examination.MethodsLUS was performed after the diagnosis of SARS-CoV-2 infection with respiratory Real Time Polymerase Chain Reaction RT-PCR with portable equipment protected with a silicone sleeve. If hemodynamic or cardiology consultation was necessary, a prepared complete ultrasound machine was used. Ten regions were explored (anterior superior and inferior, lateral, and posterior superior and inferior, right and left), and a semiquantitative score (LUSS) was calculated. Disease severity was determined with a pediatric modified score.ResultsThirty-eight patients with positive RT-PCR were admitted, 32 (81%) of which underwent LUS. Included patients had heterogenous diagnosis and gestational ages as expected on a referral neonatal intensive care unit (NICU) (median, ICR: 36, 30–38). LUS abnormalities found were B-line interstitial pattern 90%, irregular/interrupted/thick pleural line 88%, compact B-lines 65%, small consolidations (≤5 mm) 34%, and extensive consolidations (≥5 mm) 37%. Consolidations showed posterior predominance (70%). LUSS showed a median difference between levels of disease severity and ventilatory support (Kruskal–Wallis, p = 0.001) and decreased with patient improvement (Wilcoxon signed-rank test p = 0.005). There was a positive correlation between LUSS and FiO2 needed (Spearman r = 0.72, p = 0.01). The most common recommendation to the attending team was pronation (41%) and increase in positive end expiratory pressure (34%). Five patients with comorbidities died. A significant rank difference of LUSS and FiO2 needed between survivors and non-survivors was found (Mann–Whitney U-test, p = 0.005).ConclusionLUS patterns found were like the ones described in other series (neonatal and pediatrics). Eighty-eight percent of the studies were performed with handheld affordable equipment. While there is no specific pattern, it varies according to gestational age and baseline diagnosis LUS, which were shown to be useful in assessing lung involvement that correlated with the degree of disease severity and respiratory support.

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Section: Methodsmentioning

confidence: 99%

Lung Ultrasound Characteristics in Neonates With Positive Real Time Polymerase Chain Reaction for SARS-CoV-2 on a Tertiary Level Referral Hospital in Mexico City

et al. 2022

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“…At the beginning of the COVID-19 pandemic, the hospital was restructured to be able to have COVID areas as well as to trace both positive cases and contacts. Villa-Guillén et al reported the restructuring of the hospital, in which it is mentioned that three COVID areas were established ( 11 ). The first area is for general pediatric care, the second for pediatric intensive care, and the third for neonatal intensive care.…”

Section: Methodsmentioning

confidence: 99%

Tracing COVID-19 Source of Infection Among Health Personnel in a Pediatric Hospital

et al. 2022

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Health personnel (HP) have been universally recognized as especially susceptible to COVID-19. In Mexico, our home country, HP has one of the highest death rates from the disease. From the beginning of the SARS-CoV-2 pandemic, an office for initial attention for HP and a call center were established at a COVID-19 national reference pediatric hospital, aimed at early detection of COVID-19 cases and stopping local transmission. The detection and call center implementation and operation, and tracing methodology are described here. A total of 1,042 HP were evaluated, with 221 positive cases identified (7.7% of all HP currently working and 26% of the HP tested). Community contagion was most prevalent (46%), followed by other HP (27%), household (14%), and hospitalized patients (13%). Clusters and contact network analysis are discussed. This is one of the first reports that address the details of the implementation process of contact tracing in a pediatric hospital from the perspective of a hybrid hospital with COVID-19 and non-COVID-19 areas.

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“…It is important to mention that these areas do not have individual rooms and the beds are not divided from one another. The ventilation of these areas is natural and air extractors were placed ( 19 ). Visitors' access to these areas was restricted from April to June 2020; which was period 1 of the study.…”

Section: Methodsmentioning

confidence: 99%

Allowing access to parents/caregivers into COVID-19 hospitalization areas does not increase infections among health personnel in a pediatric hospital

Rosa-Zamboni

Adame-Vivanco²,

Luque-Coqui³

et al. 2022

Front. Pediatr.

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BackgroundAt the beginning of the current COVID-19 pandemic, it became critical to isolate all infected patients, regardless of their age. Isolating children has a negative effect on both, them and their parents/caregivers. Nevertheless isolation was mandatory because of the potential risk that visitation might have on COVID-19 dissemination mostly among health personnel.MethodsFrom the starting of the COVID-19 pandemic in our pediatric hospital visits were forbidden. This 2 months period (April–May) was called P1. In June parents were allowed to visit (P2), under a visiting protocol previously published. Hospital workers were monitored for the presence of COVID-19 symptoms and tested for the infection when clinically justified. The positivity proportion and the relative risk (RR) of COVID-19 among the health personnel between periods were calculated. The caregivers were also followed up by phone calls.ResultsSince April 2020 to November 2020, 2,884 health personnel were studied for 234 days, (318,146 workers days). Although the COVID-19/1,000 health personnel days rate decreased from one period to another (1.43 vs 1.23), no statistically significant differences were found. During P1, 16 patients with COVID-19 were treated. During the follow up none of the family members were infected/symptomatic in P1, while in P2, 6/129 (4.65%) were symptomatic or had a positive test. All of them initiated between 2 and 4 days after the patient's admission. As they also had some other infected family members it was not possible to ensure the source of infection. There were no statistically significant differences in the RR of COVID-19 in health personnel, (RR 1, 95% CI 0.69–1.06, p = 0.162).ConclusionsWhen safely implemented, allowing parents/caregivers to spend time with their hospitalized COVID-19 children does not increase the contagion risk for hospital workers or among themselves.

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Restructuring of a pediatric hospital in the face of the COVID-19 pandemic

Cited by 5 publications

References 0 publications

Lung Ultrasound Characteristics in Neonates With Positive Real Time Polymerase Chain Reaction for SARS-CoV-2 on a Tertiary Level Referral Hospital in Mexico City

Lung Ultrasound Characteristics in Neonates With Positive Real Time Polymerase Chain Reaction for SARS-CoV-2 on a Tertiary Level Referral Hospital in Mexico City

Tracing COVID-19 Source of Infection Among Health Personnel in a Pediatric Hospital

Allowing access to parents/caregivers into COVID-19 hospitalization areas does not increase infections among health personnel in a pediatric hospital

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