Pediatric emergency revisits of children with COVID-19.

IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Leman Akcan Yildiz, Oznur Karaca Vural, Ali Kansu Tehci, Halise Akca, Funda Kurt, Ayla Akca Caglar, Emine Dibek Misirlioglu
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引用次数: 0

Abstract

Objective: This study was conducted to reveal the characteristics of pediatric emergency revisits of children with COVID-19 and the factors associated with clinical worsening and hospitalization at the revisit.

Materials and methods: In pediatric emergency visits of children between July 2020 and March 2021 with COVID-19, the patients who had a revisit within 7 days were included in the study. Demographic and clinical characteristics, test results, and the relationship of these variables with clinical worsening and hospitalization at the revisit were investigated.

Results: In 6779 children with COVID-19, 284 (4.1%) patients included in the study. 51.8% of the patients were male, the median age was 11.1 years, and median time to revisit time was 2.0 days. The rates of clinical worsening and hospitalization were 9.1% and 14.7%, respectively. Children younger than 24 months and those with chronic diseases were more commonly hospitalized at the revisit. Though the frequency of laboratory and radiologic testing at the revisit was significantly increased compared to the first presentation, tests did not play an important role in the decision-making processes. More than 85% of patients were clinically mild at the first presentation and revisit.

Conclusions: Children with a diagnosis of COVID-19 can revisit the emergency without evident clinical worsening. Since revisits cause increase in frequency of laboratory and radiological testing, preventing unnecessary revisits of children with COVID-19 can reduce the workload and cost of health care services. We may consider changing our perspective on revisit patients to make decisions based on clinical findings instead of obtaining for more laboratory tests.

COVID-19患儿的儿科急诊就诊情况。
目的:了解新冠肺炎患儿儿科急诊复诊特点及复诊时临床恶化和住院的相关因素。材料与方法:在2020年7月至2021年3月期间COVID-19患儿的儿科急诊就诊中,将7天内再次就诊的患者纳入研究。调查了人口统计学和临床特征、测试结果以及这些变量与再次访问时临床恶化和住院的关系。结果:6779例新冠肺炎患儿中,284例(4.1%)纳入研究。51.8%的患者为男性,中位年龄11.1岁,中位回访时间2.0天。临床恶化率为9.1%,住院率为14.7%。24个月以下的儿童和患有慢性疾病的儿童在复诊时更常住院。虽然与第一次就诊相比,复诊时实验室和放射学检查的频率显著增加,但检查在决策过程中并未发挥重要作用。超过85%的患者在首次就诊和再次就诊时临床症状轻微。结论:诊断为COVID-19的儿童可在无明显临床恶化的情况下再次就诊。由于复诊导致实验室和放射检测频率增加,因此防止对COVID-19儿童进行不必要的复诊可以减少卫生保健服务的工作量和成本。我们可以考虑改变我们对复诊患者的看法,根据临床结果而不是获得更多的实验室检查来做出决定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Postgraduate Medicine
Postgraduate Medicine 医学-医学:内科
CiteScore
6.10
自引率
2.40%
发文量
110
审稿时长
6-12 weeks
期刊介绍: Postgraduate Medicine is a rapid peer-reviewed medical journal published for physicians. Tracing its roots back to 1916,  Postgraduate Medicine  was established by Charles Mayo, MD, as a peer-to-peer method of communicating the latest research to aid physicians when making treatment decisions, and it maintains that aim to this day. In addition to its core subscriber base, Postgraduate Medicine is distributed to hundreds of US-based physicians within internal medicine and family practice.
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