COVID-19 in pediatric palliative care: what can we learn from the pandemic and possible future directions

Area of Science:

• Pediatric Palliative Care
• Infectious Disease Epidemiology
• Public Health

Background:

• Patients in pediatric palliative care (PPC) often have multiple comorbidities, increasing their risk for severe COVID-19.
• Assessing the impact of SARS-CoV-2 infection and control measures in this vulnerable population is crucial.

Purpose of the Study:

• To evaluate the effectiveness of preventive strategies and testing protocols during different SARS-CoV-2 infection peaks in a pediatric palliative care setting.
• To determine the incidence and severity of COVID-19 in PPC patients and assess the impact on family support and caregiver load.

Main Methods:

• A monocentric retrospective study conducted at the Pediatric Palliative Care Center of Padua, Italy.
• Documentation and comparison of testing methodology, prevention strategies, and infection characteristics during the first and second SARS-CoV-2 peaks.
• Analysis of population swab screening, testing limitations, and restoration of family support networks.

Main Results:

• A significant reduction in family support was observed during the initial phase (April-June 2020) with population-wide screening.
• Limited swab testing and partial restoration of support networks occurred during the second peak (November 2020-January 2021).
• Low COVID-19 incidence (0.04% of regional pediatric cases) and no severe forms were observed in the PPC population.

Conclusions:

• Adequate preventive measures by families and support networks, combined with targeted testing, are safe and cost-effective.
• These strategies minimize the impact on the caregiver's care load while maintaining control over infection.
• The findings support the implementation of tailored public health interventions for vulnerable pediatric populations during pandemics.