SARS-CoV-2 COVID 19 infection

follow-up of suspected cases and contacts in the pediatric population of a tertiary care hospital

Abstract

Introduction: the World Health Organization (WHO) declared the SARS-CoV2 COVID 19 pandemic on March 11, 2020. In Uruguay, on March 13, 2020, the first cases were reported, and a state of health emergency was set up. From the beginning of the epidemic until April 27, 2021, 22,718 cases were reported in children under 15 years of age. Given this epidemiological situation, the Department of Pediatrics implemented the telephone consultations and clinical follow-up of children and adolescents (CHA) who consulted in the Pediatric Emergency and became cases and/or contacts of coronavirus disease 2019 (COVID 19).

Objective: to analyze the epidemiological and clinical characteristics of children under follow-up for suspected SARS-CoV-2 infection in a tertiary care hospital between March 1, 2020 and February 28, 2021.

Material and methods: a retrospective descriptive observational study was carried out in the period mentioned above. Patients from 0 to 14 years old who consulted in the Pediatric Emergency Department with symptoms of COVID 19 or because of a contact with a confirmed case were included. Data sources: admission statistics, medical records and laboratory. Variables: consultation date, sex, age, origin, clinic, confirmed COVID 19 contact, comorbidity, PCR test result for SARS-CoV-2, follow-up and evolution. Statistical analysis frequency distribution, summary measures and significance tests, a value of p≤0.05 was regarded as statistically significant. Ethical considerations: no specific intervention was performed, the privacy and anonymity of the people involved were guaranteed. 657 consultations were made. 455 (69.3%) by telephone, and 202 (30.7%) in person. 287 (43.7%) asymptomatic and 370 (56.3%) symptomatic: runny nose (27%), fever (23%), cough (22%), sore throat (14%), gastrointestinal (4.8%), respiratory distress (3.6%) among others. 394 patients (60%) were contacts, 254 (64.5%) intrafamily, 89 (22.6%) at school, among others. 467 (71.1%) had at least 1 follow-up, 451 (96.6%) by telephone and 16 (3.4%) in person. 78 (11.9%) were positive, 504 (76.7%) negative and 75 (11.4%) did not perform the test. 646 (98.3%) outpatients, 1 admitted to ICU. None died.

Conclusions: through telemedicine, we could implement an adequate follow-up of COVID 19 cases and contacts and identify situations that required in-person care. In most cases, the disease was resolved in an outpatient manner. Patients under 12 were more asymptomatic and the source of infection was a cohabitant more frequently than in those over 12 years of age, these differences being statistically significant (p=0.006 and p=0.005). The clinical presentation in this population was similar to reported data. The timely telephone follow-up and orientation contributed to the adoption of measures to reduce infections and viral circulation and enabled patients and families to feel physically and emotionally accompanied.