Return visit characteristics of SARS-CoV-2 PCR-positive cases in a pediatric emergency department

Authors: NİHAN ŞIK, DURGÜL ÖZDEMİR, MURAT DUMAN

Abstract: Background/aim: The aim of this study was to evaluate return visits to the pediatric emergency department (ED) for children who were detected to be positive for SARS-CoV-2 by polymerase chain reaction (PCR). Materials and methods: Between April 2, 2020, and January 20, 2021, children aged 0 to 18 years who were detected to be SARS-CoV-2 PCR-positive and discharged from the ED were evaluated. Among them, patients who returned to the ED within 14 days of quarantine were included in the study. For the first presentation and return visit, demographics, clinical findings, laboratory and radiologic investigations, and ward/pediatric intensive care unit (PICU) admissions were recorded. Patients were divided into 5 groups according to clinical severity. Results: Among 575 children who were confirmed to be SARS-CoV-2 PCR-positive, 50 (8.6%) of them [median age: 10.4 years (IQR: 4.8-15.2); 26 females] had returned. There was no difference for age, sex, underlying diseases, or symptoms for patients who returned or did not for the first presentation, but the percentage of those from whom laboratory tests were obtained was higher in cases of return visits. For symptomatic cases on the first presentation, the most common reason for return was having additional symptoms. The most common symptoms at the return visit were fever, cough, and sore throat. There was no severe/critical case in terms of clinical severity. Among all cases, 36 (72.0%) patients were discharged from the ED, 13 (26.0%) were observed for 6-8 h and then discharged, and 1 (2.0%) was admitted to the ward; there was no PICU admission or death, respectively. Conclusion: Patients who returned to the ED had mild clinical presentations. Understanding the frequency of and risk factors for return visits can clarify public health priorities such as healthcare planning to ensure the availability of resources needed for acute and follow- up care of children with COVID-19.

Keywords: Children, COVID-19, SARS-CoV-2, return, emergency department, pandemic

Full Text: PDF