A Description of COVID-19 Incidence and Outcomes in a Large Tertiary Paediatric Emergency Department

Background and Aim: SARS-CoV-2 infection presents significant challenges to the management of children. However, the direct impact on emergency and care services is only just being understood. This review aims to analyse the characteristics of SARS-CoV-2 positive children presenting to our Paediatric Emergency Department (PED) to determine patient outcomes and analyse the effectiveness of infection-control procedures. Methods: Infection control measures included adoption of hand washing, Personal Protective Equipment (PPE) and division of PED into “red” (suspected infectious) and “blue” (suspected non-infectious) zones. Retrospective data analysis was undertaken to collect information on timelines of hospital attendance, length of hospital stay (LOS) and outcomes from 15.03.2020 to 31.07.2020. Results: 27 children (0-15 years) tested COVID positive within the hospital. 22 (81.5%) of these presented to the PED among 10777 presentations. 20/22 (90.9%) patients were admitted, all were eventually discharged. The average LOS of these patients was 120.7 hours. No inter-patient SARS-CoV-2 infection transfer was seen in the ED.  Conclusions: Our study demonstrated that children don’t appear to be causing spread within our PED. Division of PED into two areas meant a substantial change to our working due to changes in staff allocation and challenges to PED leadership. Only a very small number of patients were SARS-CoV-2 positive- this leads us to believe that the current measures to split the departments are effective, but also perhaps, unnecessary.This could be crucial in anticipating and managing the future PED patient flow, especially during the winters when the other seasonal viral infections are likely to overburden the services. Funding Statement: None Declaration of Interests: The authors report no competing interests. Ethics Approval Statement: This evaluation was submitted to the University Hospitals of Leicester NHS Trust Audit and Improvement committee and ratified as a service evaluation project.