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Caring for Children With Medical Complexity in the Early COVID-19 Pandemic in an Ambulatory Primary Care Setting

Allison Driansky1,2, Mariecel Pilapil1,2, Kristina Bianco1

  • 1Steven and Alexandra Cohen Children's Medical Center, Pediatrics, New Hyde Park, NY, United States.

Frontiers in Pediatrics
|February 28, 2022
PubMed

Insights

Children with medical complexity (CMC) faced COVID-19 exposure primarily from family and caregivers. This led to significant disruptions in their essential medical care, including missed appointments and therapies during the pandemic.

Area of Science:

  • Pediatric Healthcare
  • Infectious Disease Epidemiology
  • Public Health

Background:

  • Children with medical complexity (CMC) have multiple chronic conditions and require coordinated healthcare.
  • The specific risk and impact of COVID-19 on CMC populations were not well understood at the pandemic's outset.
  • Understanding COVID-19's effect on this vulnerable group is crucial for healthcare planning.

Purpose of the Study:

  • To determine the prevalence of COVID-19 among CMC.
  • To describe the experience of COVID-19 for both CMC and their caregivers.
  • To analyze exposure sources and healthcare interruptions in this population during the early pandemic.

Main Methods:

  • A cross-sectional study design was employed.
  • The study included children enrolled in a structured clinical program for CMC.
  • Data were collected from a large urban academic general pediatrics practice in New York.

Main Results:

  • Out of 132 CMC patients, 16 had known COVID-19 exposure, with parents being the most frequent source (37.5%).
  • Two CMC patients required hospitalization for COVID-19; others were managed as outpatients.
  • Confirmed or suspected COVID-19 cases were identified within the study cohort.

Conclusions:

  • Family members and home care providers were identified as common sources of COVID-19 transmission to CMC.
  • Nearly all CMC patients in the study experienced significant interruptions to their medical care.
  • Missed therapies and appointments were frequently reported consequences of the pandemic for these children.
Abstract

Keywords:
COVID-19caregiverschildren with medical complexitycomplex caregeneral pediatrics

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