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COVID-19 Screening in the Pediatric Emergency Department
Background:Screening for COVID-19 infection in pediatrics is challenging as its clinical presentation may be asymptomatic or mimic other common childhood infections. We examined the use of a COVID-19 screening protocol (CSP) in the pediatric emergency department (PED) to determine the incidence of p...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10066930/ https://www.ncbi.nlm.nih.gov/pubmed/37016637 http://dx.doi.org/10.7759/cureus.35731 |
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author | Hammett, Deborah L Loiselle, Claire Palmer, Kathleen M Loiselle, John M Attia, Magdy W |
author_facet | Hammett, Deborah L Loiselle, Claire Palmer, Kathleen M Loiselle, John M Attia, Magdy W |
author_sort | Hammett, Deborah L |
collection | PubMed |
description | Background:Screening for COVID-19 infection in pediatrics is challenging as its clinical presentation may be asymptomatic or mimic other common childhood infections. We examined the use of a COVID-19 screening protocol (CSP) in the pediatric emergency department (PED) to determine the incidence of positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) tests in patients who are CSP+ and CSP-. Methods: We conducted a retrospective cohort study of pediatric patients with SARS-CoV-2 testing completed in an urban tertiary care PED from November 1 to December 31, 2020. Demographics, CSP designation, test results, and disposition were compared. Statistical significance was determined using chi-square or a comparison of means. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) with 95% confidence intervals (CI) were calculated. Results: A total of 1,613 patients had SARS-CoV-2 tests completed with 9.1% (N=147) having positive test results. Of 1,014 (62.9%) patients who were CSP+, 12.9% tested positive. Comparatively, 599 (37.1%) patients were CSP- with only 2.7% positive tests, p<0.0001. The sensitivity, specificity, NPV, and PPV of the CSP in all tested patients were 89.1%, 39.8%, 97.3%, and 12.9%, respectively. Of tested patients, 887 (55.0%) were admitted to the hospital and were more likely to be positive if CSP+, p≤0.001. Within the admitted group, 16.8% were admitted to the operating room, of whom 83.9% were CSP- with 4.0% testing positive for SARS-CoV-2. Conclusions: COVID-19 screening in the pediatric population is a useful modality to risk stratify most patients presenting to the PED for the purpose of selective testing and guiding personal protective equipment use. This may be particularly useful in low-resource settings. |
format | Online Article Text |
id | pubmed-10066930 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-100669302023-04-03 COVID-19 Screening in the Pediatric Emergency Department Hammett, Deborah L Loiselle, Claire Palmer, Kathleen M Loiselle, John M Attia, Magdy W Cureus Emergency Medicine Background:Screening for COVID-19 infection in pediatrics is challenging as its clinical presentation may be asymptomatic or mimic other common childhood infections. We examined the use of a COVID-19 screening protocol (CSP) in the pediatric emergency department (PED) to determine the incidence of positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) tests in patients who are CSP+ and CSP-. Methods: We conducted a retrospective cohort study of pediatric patients with SARS-CoV-2 testing completed in an urban tertiary care PED from November 1 to December 31, 2020. Demographics, CSP designation, test results, and disposition were compared. Statistical significance was determined using chi-square or a comparison of means. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) with 95% confidence intervals (CI) were calculated. Results: A total of 1,613 patients had SARS-CoV-2 tests completed with 9.1% (N=147) having positive test results. Of 1,014 (62.9%) patients who were CSP+, 12.9% tested positive. Comparatively, 599 (37.1%) patients were CSP- with only 2.7% positive tests, p<0.0001. The sensitivity, specificity, NPV, and PPV of the CSP in all tested patients were 89.1%, 39.8%, 97.3%, and 12.9%, respectively. Of tested patients, 887 (55.0%) were admitted to the hospital and were more likely to be positive if CSP+, p≤0.001. Within the admitted group, 16.8% were admitted to the operating room, of whom 83.9% were CSP- with 4.0% testing positive for SARS-CoV-2. Conclusions: COVID-19 screening in the pediatric population is a useful modality to risk stratify most patients presenting to the PED for the purpose of selective testing and guiding personal protective equipment use. This may be particularly useful in low-resource settings. Cureus 2023-03-03 /pmc/articles/PMC10066930/ /pubmed/37016637 http://dx.doi.org/10.7759/cureus.35731 Text en Copyright © 2023, Hammett et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Emergency Medicine Hammett, Deborah L Loiselle, Claire Palmer, Kathleen M Loiselle, John M Attia, Magdy W COVID-19 Screening in the Pediatric Emergency Department |
title | COVID-19 Screening in the Pediatric Emergency Department |
title_full | COVID-19 Screening in the Pediatric Emergency Department |
title_fullStr | COVID-19 Screening in the Pediatric Emergency Department |
title_full_unstemmed | COVID-19 Screening in the Pediatric Emergency Department |
title_short | COVID-19 Screening in the Pediatric Emergency Department |
title_sort | covid-19 screening in the pediatric emergency department |
topic | Emergency Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10066930/ https://www.ncbi.nlm.nih.gov/pubmed/37016637 http://dx.doi.org/10.7759/cureus.35731 |
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