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Infection control strategy and primary care assistance in Campania region during the national lockdown due to COVID-19 outbreak: the experience of two tertiary emergency centers.
Mauro, Angela; Improda, Nicola; Zenzeri, Letizia; Valitutti, Francesco; Vecchione, Erica; Esposito, Sara; Tipo, Vincenzo.
  • Mauro A; Emergency Pediatric Department, Pediatric Emergency Unit, AORN Santobono-Pausilipon Children's Hospital, Via Mario Fiore 6, 80131, Naples, Italy. angela.mauro84@gmail.com.
  • Improda N; EBRIS (European Biomedical Research Institute of Salerno), Salerno, Italy. angela.mauro84@gmail.com.
  • Zenzeri L; Emergency Pediatric Department, Pediatric Emergency Unit, AORN Santobono-Pausilipon Children's Hospital, Via Mario Fiore 6, 80131, Naples, Italy.
  • Valitutti F; Pediatric Section, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.
  • Vecchione E; Emergency Pediatric Department, Pediatric Emergency Unit, AORN Santobono-Pausilipon Children's Hospital, Via Mario Fiore 6, 80131, Naples, Italy.
  • Esposito S; EBRIS (European Biomedical Research Institute of Salerno), Salerno, Italy.
  • Tipo V; Pediatric Unit, AOU San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy.
Ital J Pediatr ; 47(1): 19, 2021 Jan 29.
Article in English | MEDLINE | ID: covidwho-1054827
ABSTRACT

BACKGROUND:

COVID-19 pandemic has markedly affected emergency care, due to sudden limitation of health care capacity by general practitioners (GP) and urgent need for infection control strategies. We evaluated the activity of the Emergency Department (ED) during the national lockdown (March 8-April 30), as well as the outcomes of our infection control strategy.

RESULTS:

Despite a reduction in access by one fifth, a proportion of febrile patients comparable to 2019 was seen (829/2492, 33.3% vs 4580/13.342, 34.3%, p = 0.3). Diagnostic swab for COVID-19 was performed in 25% of patients, especially in subjects with co-morbidities or multiple access. Six infected cases were identified, all presenting with febrile disease. Only two positive patients fulfilled the criteria for diagnostic swab provided by the Italian Health Authorities, because of close contact with suspected or confirmed cases. The rate of admission for febrile or respiratory conditions was higher than the same period of 2019 (33.4% vs 25.9%, p < 0.0001). None of the 105 health-care professionals working during the study time lapse exhibited anti-SARS-CoV-2 seroconversion. Among the 589 patients with information available, 54.9% declared no medical consultation at all prior to coming to ED, while only 40 (of which 27 with fever) had been examined by their GP before coming to ED. Nevertheless, 35.6% of the cases were already taking medications. None of the 9 patients requiring intensive care reported recent pediatric consultation, despite symptoms duration up to 30 days.

CONCLUSION:

Our results provide evidence that the reduced capacity of primary care facilities during the national lockdown may have caused a high rate of self-medication as well as a delayed provision of care in some patients. Identification of pediatric patients affected with SARS-CoV-2 infection remains a challenge because of the absence of reliable predictive factors. Finally, the use of specific triage centers, with dedicated pathways to diagnose SARS-CoV-2 infection, trace contacts and allow adequate care after swabs, is effective in preventing spreading of the infection.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Infection Control / Emergency Service, Hospital / Pandemics / COVID-19 / Hospitals, Pediatric Type of study: Experimental Studies / Observational study / Prognostic study Limits: Child / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Ital J Pediatr Journal subject: Pediatrics Year: 2021 Document Type: Article Affiliation country: S13052-021-00963-3

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Infection Control / Emergency Service, Hospital / Pandemics / COVID-19 / Hospitals, Pediatric Type of study: Experimental Studies / Observational study / Prognostic study Limits: Child / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Ital J Pediatr Journal subject: Pediatrics Year: 2021 Document Type: Article Affiliation country: S13052-021-00963-3