Health-care organization for the management and surveillance of SARS-CoV-2 infection in children during pandemic in Camp
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(2020) 46:170
RESEARCH
Open Access
Health-care organization for the management and surveillance of SARSCoV-2 infection in children during pandemic in Campania region, Italy Francesco Nunziata1* , Eugenia Bruzzese1, Marco Poeta1, Luca Pierri1, Andrea Catzola1, Gian Paolo Ciccarelli1, Edoardo Vassallo1, Emma Montella2, Andrea Lo Vecchio1 and Alfredo Guarino1
Abstract Background: In comparison with adults, severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection in children has a milder course. The management of children with suspected or confirmed coronavirus disease (COVID-19) needs to be appropriately targeted. Methods: We designed a hub-and-spoke system to provide healthcare indications based on the use of telemedicine and stringent admission criteria, coordinate local stakeholders and disseminate information. Result: Between March 24th and September 24th 2020, the Hub Centre managed a total of 208 children (52% males, median age, 5.2, IQR 2–9.6 years) with suspected or confirmed COVID-19. Among them, 174 were managed in cooperation with family pediatricians and 34 with hospital-based physicians. One hundred-four (50%) received a final diagnosis of SARS-CoV-2 infection. Application of stringent criteria for hospital admission based on clinical conditions, risk factors and respect of biocontainment measures, allowed to manage the majority of cases (74, 71.1%) through telemedicine. Thirty children (28%) were hospitalized (median length 10 days, IQR 5–19 days), mainly due to the presence of persistent fever, mild respiratory distress or co-infection occurring in infant or children with underlying conditions. However, the reasons for admission slightly changed over time. Conclusion: An hub-and-spoke system is effective in coordinate territorial health-care structures involved in management paediatric COVID-19 cases through telemedicine and the definition of stringent hospital admission criteria. The management of children with COVID-19 should be based on clinical conditions, assessed on a case-by-case critical evaluation, as well as on isolation measures, but may vary according to local epidemiological changes. Keywords: Children, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19, Management
* Correspondence: [email protected] 1 Department of Translational Medical Sciences – Paediatrics Section, University of Naples Federico II, via Pansini 5, 80134 Naples, Italy Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the mater
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