COVID-19 Screening in the Pediatric Emergency Department

Area of Science:

• Pediatric Emergency Medicine
• Infectious Disease Epidemiology
• Clinical Diagnostics

Background:

• Pediatric COVID-19 screening presents challenges due to asymptomatic cases and symptom overlap with common childhood illnesses.
• Accurate identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is crucial for patient management and infection control.

Purpose of the Study:

• To evaluate the effectiveness of a COVID-19 screening protocol (CSP) in a pediatric emergency department (PED).
• To determine the incidence of positive SARS-CoV-2 polymerase chain reaction (PCR) tests among CSP-positive (CSP+) and CSP-negative (CSP-) pediatric patients.

Main Methods:

• Retrospective cohort study of pediatric patients undergoing SARS-CoV-2 testing in an urban tertiary care PED.
• Comparison of demographics, CSP status, test results, and patient disposition.
• Calculation of sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) for the CSP.

Main Results:

• A total of 1,613 patients were tested, with a 9.1% overall positive rate for SARS-CoV-2.
• CSP+ patients had a 12.9% positive rate, significantly higher than the 2.7% rate in CSP- patients (p<0.0001).
• The CSP demonstrated a sensitivity of 89.1% and an NPV of 97.3%.

Conclusions:

• The COVID-19 screening protocol is a valuable tool for risk stratification in pediatric emergency settings.
• The CSP aids in guiding selective testing and optimizing personal protective equipment usage.
• This screening approach may be particularly beneficial in resource-limited environments.