COVID-19 Outbreak Among Adolescents at an Inpatient Behavioral Health Hospital

PURPOSE: We report on a coronavirus disease 2019 (COVID-19) outbreak among adolescents at an inpatient behavioral health facility that was identified within 5 weeks of known viral transmission in the surrounding community. METHODS: Clinical records were reviewed for all inpatients aged <18 years with laboratory-confirmed COVID-19 between March 23 and April 21, 2020. RESULTS: A total of 19 COVID-19–positive patients aged 11–17 years were identified. Patients most commonly presented with sore throat (37%) and nausea/vomiting (32%). Only 26% of patients presented with cough, shortness of breath, or fever. The most common medical comorbidity was asthma (32%), and the most common psychiatric comorbidity was posttraumatic stress disorder (63%). Infected patients were colocated and managed together on a separate COVID-19 unit to maintain a therapeutic group milieu. Mental health treatment was modified to limit staff exposure. Patients received daily medical assessment by an in-house pediatrician. One patient required intravenous fluids. No patients required transfer to a medical facility. CONCLUSIONS: Adolescents in psychiatric inpatient settings may be especially vulnerable to COVID-19 infection. Close collaboration between medical and psychiatric care providers is needed to optimize care for this population and to address admission and disposition options for infected patients.