Social Science Research Network | 2021
COVID-19 and Pediatric Emergency Department: The Impact of National Containment Measures on an Italian Regional Hub for COVID-19
Abstract
Background: Numerous studies described the epidemiological link and main clinical features of pediatric COVID-19, during the first pandemic period, while this is the first study that encompass several different phases of National Lockdown in a European country. We described the effects of different National Containment Measures on positive NST (Nasopharyngeal Swab Test) trend, epidemiological links and main clinical features of the largest Italian Pediatric cohort admitted to a single regional Pediatric Emergency Department Hub for COVID-19, during an eight-month period. \n \nMethods: We described 316 patients with a positive NST for SARS-CoV2, on a total of 5001 nasopharyngeal swabs performed among 13171 admissions at our PED, over a period starting from March 17th, 2020 to December 1st, 2020. Age, epidemiological link, clinical features and hospitalizations were analyzed according to different lockdown phases. Data were collected anonymously from electronic records and analyzed using SPSS 22.00 statistics software (Chicago, IL). \n \nFindings: Thirty-six percent of total admissions have been tested for SARS-CoV2. During the post Lockdown period we performed the highest percentage of NST (Nasopharyngeal Swab Test) 49,7% and found the highest percentage of positive NST on total NST effectuated 7,9%. Mean age was 6.5 years old.\xa0The 0-6 years age group accounted the highest number of positive NST. Familial link is predominant during all phases; however, we observed an increase of extra-familial and unknown link starting from the phase 4, especially among adolescents. Seventeen patients showed an intra-scholastic link. Older children were frequently symptomatic and accounted for the 1% admission in ICU (Intensive Care Unit). Seven patients were admitted with MIS-C diagnosis. \n \nInterpretation: Different levels of containment measures caused important changes in epidemiological link, mean age and number of admissions and hospitalization of patients with COVID-19. Familial link was predominant in our cohort, during all phases of Lockdown, yet the impact on extrafamilial link and intra-scholastic link should be further investigated. Adolescent and young adults could present more frequently with moderate/severe symptoms requiring, in rare cases, admission in ICU. \n \nFunding Statement: No funding was secured for this study. \n \nDeclaration of Interests: The authors have no conflicts of interest to disclose. \n \nEthics Approval Statement: This study was approved by the institutional review board of Bambino \nGesu Children Hospital, IRCCS.