183 - Out-patient Care for Children Infected with SARS-CoV-2, at a Designated Pediatric COVID Clinic

Poster Number: 183
Publication Number: 183.317

Allison M. Galkowski, M Health Physicians, Saint Paul, MN, United States; Bazak Sharon, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, United States

Background: SSARS-CoV-2 has infected millions of children around the world, some with grave consequences. Early in the pandemic it was clear that most children would not require hospital admission, and that pediatric care will be predominantly at the out-patient setting. Yet, no clear guidelines exist, and providers are challenged with the management of various illnesses that have (and still) emerge during the Covid-19 pandemic. Pediatric Covid care should follow a holistic, longitudinal, and accessible model that involve primary and specialized clinics.

Objective: To describe the spectrum of disease and care delivered at a designated pediatric Covid clinic.

Design/Methods: The Pediatric Covid Clinic at the University of Minnesota has been accepting referrals from multiple clinical settings throughout the Upper Midwest since April 2020. The clinic is participating in a national registry for children infected with SARS-CoV-2 (PIDTRAN-6_Covid-19), allowing us to collect and archive anonymized clinical data. Following IRB approved protocol, we collected demographic data and clinical information including from children with confirmed SARS-CoV-2 infection.

Results: A total of 106 children were seen at our specialized clinic. 42 children were seen for post admission follow-up, predominantly after acute Covid or multisystem inflammatory syndrome in children and 62 were scheduled for an out-patient consultation (by providers or self-referred). Long Covid was the reason for referrals in 37 patients, followed by 22 with current acute Covid of them 8 children who are medically complex, and parental/provider concerns (5). As needed, patients were further referred to variety of specialize clinics and at least 20 children with long Covid were also seen at other clinics, usually Integrative Medicine, Physical Therapy, and Cardiology [Figure 1]. Of the children seen at the referral clinic, 23% were from outside the Twin Cities metro area, significantly lower than their portion (34%) in the overall SARS-CoV-2 registry [Figure 2].Conclusion(s): LLong Covid is the most common reason for referral for specialized pediatric Covid care, accounting for more than half of patients. Out-patient care is also important for acute illness, both in healthy children and those with pre-existing diseases as it prevent unnecessary admission and can direct post-exposure interventions. Care for children with long Covid requires multidisciplinary longitudinal approach and should stem from primary care, with specialized care support. Children from the periphery are underrepresented at referral centers, raising concerns about lack of access to care.
Figure 1: Referrals to- and from- Pediatric Covid ClinicMISC: Multisystem inflammatory syndrome in children. Total number of referrals to other clinics is specified by (N).
Figure 2: Demographic distribution (based on zip codes) of children from a large SARS-CoV-2 registry (Nf7404) and those referred to Pediatric Covid clinic (Nf64)