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Facing SARS-CoV-2 Pandemic at a COVID-19 Regional Children's Hospital in Italy.
Pediatr Infect Dis J. 2020 09; 39(9):e221-e225.PI

Abstract

BACKGROUND

In Italy, the response to coronavirus disease 2019 (COVID-19) pandemic upgraded from social distancing on February 23, 2020, to national lockdown on March 11, 2020. We described how the pandemic affected a tertiary care children hospital with a dedicated COVID-19 regional center.

METHODS

We analyzed the characteristics of emergency department (ED) visits, urgent hospitalizations and severe acute respiratory syndrome (SARS)-COV-2 reverse transcription-polymerase chain reaction testing, and COVID-19 patients across 3 response phases: before the first Italian case, before national lockdown and during lockdown.

RESULTS

ED visits decreased from a daily mean of 239.1 before the first COVID-19 Italian case, to 79.6 during lockdown; urgent hospitalizations decreased from 30.6 to 21.2. As of April 20, 2020, 1970 persons were tested for SARS-CoV-2 reverse transcription-polymerase chain reaction and 2.6% were positive. Positive rates were 1.2% in the ED, 21.1% in the COVID center and 0.5% in other wards. The median age of COVID-19 patients (N = 33) was 6.7 years, 27% had coexisting conditions and 79% were related to family clusters.

CONCLUSIONS

The pandemic strongly impacted on the use of hospital services, with a 67% reduction in ED visits and a 31% reduction in urgent hospitalizations. Separating the flows of suspected patients from all other patients, and centralization of suspected and confirmed cases in the COVID center enabled to control the risk of nosocomial SARS-CoV-2 transmission. Delay in hospital use for urgent care must be avoided, and clear communication on infection prevention and control must be provided to families. Further studies are needed to assess how the reduction in hospital use affected children healthcare needs during the pandemic.

Authors+Show Affiliations

From the Clinical Pathways and Epidemiology Unit, Medical Direction.University Department of Pediatrics.Department of Laboratories.Department of Laboratories.From the Clinical Pathways and Epidemiology Unit, Medical Direction.From the Clinical Pathways and Epidemiology Unit, Medical Direction.Emergency Department.Emergency Department.University Department of Pediatrics.University Department of Pediatrics.University Department of Pediatrics.Medical Direction, Bambino Gesù Children's Hospital, Rome, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32639459

Citation

Ciofi Degli Atti, Marta Luisa, et al. "Facing SARS-CoV-2 Pandemic at a COVID-19 Regional Children's Hospital in Italy." The Pediatric Infectious Disease Journal, vol. 39, no. 9, 2020, pp. e221-e225.
Ciofi Degli Atti ML, Campana A, Muda AO, et al. Facing SARS-CoV-2 Pandemic at a COVID-19 Regional Children's Hospital in Italy. Pediatr Infect Dis J. 2020;39(9):e221-e225.
Ciofi Degli Atti, M. L., Campana, A., Muda, A. O., Concato, C., Ravà, L., Ricotta, L., Reale, A., Barbieri, M., D'Argenio, P., Lancella, L., Villani, A., & Raponi, M. (2020). Facing SARS-CoV-2 Pandemic at a COVID-19 Regional Children's Hospital in Italy. The Pediatric Infectious Disease Journal, 39(9), e221-e225. https://doi.org/10.1097/INF.0000000000002811
Ciofi Degli Atti ML, et al. Facing SARS-CoV-2 Pandemic at a COVID-19 Regional Children's Hospital in Italy. Pediatr Infect Dis J. 2020;39(9):e221-e225. PubMed PMID: 32639459.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Facing SARS-CoV-2 Pandemic at a COVID-19 Regional Children's Hospital in Italy. AU - Ciofi Degli Atti,Marta Luisa, AU - Campana,Andrea, AU - Muda,Andrea Onetti, AU - Concato,Carlo, AU - Ravà,Lucilla, AU - Ricotta,Lara, AU - Reale,Antonino, AU - Barbieri,Maria, AU - D'Argenio,Patrizia, AU - Lancella,Laura, AU - Villani,Alberto, AU - Raponi,Massimiliano, PY - 2020/7/9/pubmed PY - 2020/8/29/medline PY - 2020/7/9/entrez SP - e221 EP - e225 JF - The Pediatric infectious disease journal JO - Pediatr. Infect. Dis. J. VL - 39 IS - 9 N2 - BACKGROUND: In Italy, the response to coronavirus disease 2019 (COVID-19) pandemic upgraded from social distancing on February 23, 2020, to national lockdown on March 11, 2020. We described how the pandemic affected a tertiary care children hospital with a dedicated COVID-19 regional center. METHODS: We analyzed the characteristics of emergency department (ED) visits, urgent hospitalizations and severe acute respiratory syndrome (SARS)-COV-2 reverse transcription-polymerase chain reaction testing, and COVID-19 patients across 3 response phases: before the first Italian case, before national lockdown and during lockdown. RESULTS: ED visits decreased from a daily mean of 239.1 before the first COVID-19 Italian case, to 79.6 during lockdown; urgent hospitalizations decreased from 30.6 to 21.2. As of April 20, 2020, 1970 persons were tested for SARS-CoV-2 reverse transcription-polymerase chain reaction and 2.6% were positive. Positive rates were 1.2% in the ED, 21.1% in the COVID center and 0.5% in other wards. The median age of COVID-19 patients (N = 33) was 6.7 years, 27% had coexisting conditions and 79% were related to family clusters. CONCLUSIONS: The pandemic strongly impacted on the use of hospital services, with a 67% reduction in ED visits and a 31% reduction in urgent hospitalizations. Separating the flows of suspected patients from all other patients, and centralization of suspected and confirmed cases in the COVID center enabled to control the risk of nosocomial SARS-CoV-2 transmission. Delay in hospital use for urgent care must be avoided, and clear communication on infection prevention and control must be provided to families. Further studies are needed to assess how the reduction in hospital use affected children healthcare needs during the pandemic. SN - 1532-0987 UR - https://www.unboundmedicine.com/medline/citation/32639459/Facing_SARS_CoV_2_Pandemic_at_a_COVID_19_Regional_Children's_Hospital_in_Italy_ L2 - https://doi.org/10.1097/INF.0000000000002811 DB - PRIME DP - Unbound Medicine ER -