Home Management of Children With COVID-19 in the Emilia-Romagna Region, Italy

Frontiers in Pediatrics

article

Gianluca Vergine¹  Anna Maria Magista²  Francesca Vaienti³  Andrea Cella⁴  Paola Affanni⁵  Maria Carla Re⁶  Vittorio Sambri⁷  Susanna Esposito⁸  Michela Fantini⁷  Federico Marchetti⁹  Marcello Stella¹  Enrico Valletta³  Giacomo Biasucci⁴  Marcello Lanari⁶  Icilio Dodi⁸  Maurizio Bigi² 

[1] Department of Pediatrics, Infermi Hospital Rimini;Pediatric Community Unit;Pediatric Clinic;Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital;Laboratory of Hygiene and Public Health, Department of Medicine and Surgery, University of Parma;Microbiology Unit, University of Bologna;Unit of Microbiology, The Great Romagna Area Hub Laboratory;Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma;Department of Pediatrics, Santa Maria delle Croci Hospital

关键词: community health service;    COVID-19;    home management;    pediatric infectious diseases;    SARS-COV-2;   

DOI  :  10.3389/fped.2020.575290

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

In most children, coronavirus disease 2019 (COVID-19) is a mild or moderate disease. Moreover, in a relevant number of cases, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains totally asymptomatic. All these findings seem to suggest that otherwise healthy children with suspected COVID-19 might be managed in the community in most cases, thus avoiding hospital admission and closely related medical, social and economic problems, including overwhelming hospitals. Unfortunately, home management of children with suspected COVID-19 rarely occurs, and many children with suspected or laboratory-confirmed SARS-CoV-2 infection are frequently hospitalized irrespective of the severity of disease. To evaluate the role of community health houses (CHHs) in the management of children with COVID-19, 1,009 children with suspected SARS-CoV-2 infection were studied in Emilia-Romagna Region, Italy. Among them, 194 (19.2%) resulted positive for SARS-CoV-2. The majority (583, 58%) were tested at home by CHHs, while 426 (42%) were brought to the hospital for testing. The patients who were managed in the hospital had a significantly lower median age than those who were managed at home (2 vs. 12 years, p < 0.001). Exposure to SARS-CoV-2 cases within the family was significantly more frequent among those who were managed at home (82 vs. 46%, p < 0.05). The clinical findings were similar between the children who were managed at home and those who were managed in the hospital. Only one of the children managed at home (0.7%) required hospitalization; in comparison, 26 (48%) of those whose swab samples were taken at the hospital were hospitalized. Our research shows for the first time the importance of CHHs in the management of COVID-19 in children; because of the high frequency of mild to moderate cases, management by CHHs can reduce the care load in hospitals, providing enormous advantages on the familial, medical, social, and economic levels. These findings could be useful for suggesting a territorial rather than hospital-based strategy in pediatrics in the case of a new wave of the epidemic.

【 授权许可】

CC BY