1001 The presentations and management of acute Covid-19 infection in secondary care in South East Scotland. (17th August 2022)

• Record Type: Journal Article
• Authors: McManus, Hannah; Jones, Laura
• Is Part Of: Archives of disease in childhood. Volume 107(2022)Supplement 2
• Page Start: A211
• Page End: A212
• Publication Date: 2022-08-17
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2022-rcpch.340
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: To review the presentations and management of children and young people presenting with acute Covid-19 requiring hospital admission in South East Scotland. Methods: Retrospective identification of children testing positive for Covid-19 infection at time of admission to the Royal Hospital for Children and Young People (RHCYP) in Edinburgh over a 10 month period from March 2021 to January 2022 inclusive, with review of their presentations and management. Patients who presented with PIMS-TS were excluded. Results: 109 children who were admitted to RHCYP over a 10 month period, tested positive for Covid-19 infection on day of admission, age range of 2 days to 16 years old. The mean age at presentation was 4 years and 1 month of age, with 39% of children ( 43 ) under 6 months of age, 28% ( 31 ) between 6 months and 5 years of age, 16% aged 5 to 12 years of age (17) and 17% aged over 12 years (18). Children with symptomatic Covid-19 infection had a wide array of presentations, including viral induced wheeze, bronchiolitis, croup and superimposed pneumonia, with the most commonly utilised treatments being oxygen, steroids and nebulisers. However, in those under 6 months of age, only 23% required any treatment for Covid-19 infection, whilst 58% of those aged 6 months to 5 years required treatment for symptomatic Covid-19 infection. Only 37% (40) of children presenting with Covid-19 infection required treatment for respiratory tract infection. In those children requiring treatment for symptomatic respiratory tract infection, the most commonly utilised treatments in the ward setting were oxygen (24, 60%), steroids (20, 50%) and nebulisers or inhaled bronchodilators (12, 30%); only one child required treatment with remdesivir (0.9%). Patients presenting under 3 months of age with pyrexia and Covid-19 positive frequently received IV antibiotics to cover pyrexia of unknown origin until microbiology was returned, with no other specific treatment required (13, 12%). Conclusion: Of the 109 patients admitted with or because of Covid-19, the majority were under 6 months of age, whilst children aged 6 months to 5 years more commonly required specific treatment for Covid-19 infection. Many of these 109 children with Covid-19 infection did not require any treatment ( 45, 40%), or were treated for other illnesses with Covid-19 felt to be incidental (9, 8.3%). Many ( 25, 23 % ) children tested positive for multiple viruses including Covid-19, making the particular burden of Covid-19 infection unclear.