Visits for Possible COVID-19 in a Pediatric Primary Care Practice Early in the Pandemic

Area of Science:

• Pediatric infectious diseases
• Public health surveillance
• Epidemiology of viral infections

Background:

• Children with COVID-19 typically exhibit mild symptoms.
• Understanding outpatient pediatric encounters for COVID-19 is crucial for public health management.
• Characterizing symptoms and testing patterns in pediatric primary care settings provides valuable insights.

Purpose of the Study:

• To characterize the symptoms and COVID-19 testing practices for pediatric sick visits in an outpatient academic setting.
• To identify factors associated with positive COVID-19 tests in children.
• To evaluate the proportion of sick visits attributed to potential COVID-19 cases.

Main Methods:

• Retrospective chart review of sick visits at a pediatric academic primary care clinic (April-August 2020).
• Inclusion criteria: "persons under investigation" (PUIs) for COVID-19, recording symptoms, known COVID-19 contacts, and testing status.
• Descriptive statistics and inferential tests (Chi-square/Fisher's exact) were employed for data analysis.

Main Results:

• 32% of sick visits involved PUIs for COVID-19; 20% of these were via telehealth.
• The most frequent symptoms reported were fever, congestion/rhinorrhea, and cough.
• COVID-19 testing was performed on 76% of PUIs; only known contacts and loss of taste/smell significantly predicted positive tests.

Conclusions:

• A substantial proportion of pediatric sick visits were for potential COVID-19, with most patients undergoing testing.
• Fever, congestion, and cough were common symptoms in children with and without COVID-19.
• The study suggests a low threshold for COVID-19 testing in pediatric patients presenting with relevant symptoms.