ABSTRACT
Objectives: To measure the prevalence of viral infections, length of stay (LOS), and outcome in children admitted to the pediatric intensive care unit (PICU) during the period preceding the COVID-19 pandemic in a MERS-CoV endemic country. Methods: A retrospective chart review of children 0–14 years old admitted to PICU with a viral infection. Results: Of 1736 patients, 164 patients (9.45%) had a positive viral infection. The annual prevalence trended downward over a three-year period, from 11.7% to 7.3%. The median PICU LOS was 11.6 days. Viral infections were responsible for 1904.4 (21.94%) PICU patient-days. Mechanical ventilation was used in 91.5% of patients, including noninvasive and invasive modes. Comorbidities were significantly associated with intubation (P-value = 0.025). Patients infected with multiple viruses had median pediatric index of mortality 2 (PIM 2) scores of 4, as compared to 1 for patients with single virus infections (p < 0.001), and a median PICU LOS of 12 days, compared to 4 in the single-virus group (p < 0.001). Overall, mortality associated with viral infections in PICU was 7 (4.3%). Patients with viral infections having multiple organ failure were significantly more likely to die in the PICU (p = 0.001). Conclusion: Viral infections are responsible for one-fifth of PICU patient-days, with a high demand for mechanical ventilation. Patients with multiple viral infections had longer LOS, and higher PIM 2 scores. The downward trend in the yearly rate of PICU admissions for viral infections between the end of the MERS-CoV outbreak and the start of the COVID-19 pandemic may suggest viral interference that warrants further investigations. © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases
ABSTRACT
OBJECTIVES: To measure the prevalence of viral infections, length of stay (LOS), and outcome in children admitted to the pediatric intensive care unit (PICU) during the period preceding the COVID-19 pandemic in a MERS-CoV endemic country. METHODS: A retrospective chart review of children 0-14 years old admitted to PICU with a viral infection. RESULTS: Of 1736 patients, 164 patients (9.45%) had a positive viral infection. The annual prevalence trended downward over a three-year period, from 11.7% to 7.3%. The median PICU LOS was 11.6 days. Viral infections were responsible for 1904.4 (21.94%) PICU patient-days. Mechanical ventilation was used in 91.5% of patients, including noninvasive and invasive modes. Comorbidities were significantly associated with intubation (P-value = 0.025). Patients infected with multiple viruses had median pediatric index of mortality 2 (PIM 2) scores of 4, as compared to 1 for patients with single virus infections (p < 0.001), and a median PICU LOS of 12 days, compared to 4 in the single-virus group (p < 0.001). Overall, mortality associated with viral infections in PICU was 7 (4.3%). Patients with viral infections having multiple organ failure were significantly more likely to die in the PICU (p = 0.001). CONCLUSION: Viral infections are responsible for one-fifth of PICU patient-days, with a high demand for mechanical ventilation. Patients with multiple viral infections had longer LOS, and higher PIM 2 scores. The downward trend in the yearly rate of PICU admissions for viral infections between the end of the MERS-CoV outbreak and the start of the COVID-19 pandemic may suggest viral interference that warrants further investigations.
ABSTRACT
AIMS & OBJECTIVES: A key measure to mitigate COVID-19 has been social distancing. Incorporating videoconferencing Apps in patients' handover process between HCWs can enhance social distancing while maintaining handover elements. This research aimed to describe PICU physicians' experience in using online videoconferencing App for handover during the pandemic. METHODS: This is a qualitative content analysis at a university hospital in Riyadh, KSA. Since May 15th, 2020, due to the pandemic, our PICU utilized Zoom® as a remote conferencing App, instead of face-to-face handover. After the IRB approval, data were collected over two weeks (July 1-14th, 2020) through an online structured questionnaire. Demographic data and open-ended questions about the perceived efficacy of the remote handover were collected. The analysis process included open coding, creating categories, and abstraction. RESULTS: From the 36 PICU physicians who participated, 30 (83.3%) completed the survey. Participants included 6 attendings, 9 specialists, and 21 residents. They had variable previous teleconferencing experience (Table). Most physicians (75%) were comfortable conducting a remote endorsement. The majority found that SBAR handover elements were achieved through this remote handover process (Fig). The perceived advantages of online handover included fewer interruptions, time efficiency, and facilitation of social distancing. Perceived disadvantages were the paucity of non-verbal communication and teaching during virtual meetings. CONCLUSIONS: Videoconferencing Apps utilized for online handover could supplement traditional face-to-face ICU patients' endorsement during infectious disease outbreaks. Some changes should be implemented to optimize the users' experience.