Seguimiento telemático de COVID-19: experiencia de un hospital terciario
Javier Nogueira López, Carlos Grasa Lozano, Cristina Ots Ruiz, Luis Alonso García, Iker Falces-Romero, Cristina Calvo, Milagros García-López Hortelano
Anales de Pediatría, doi:10.1016/j.anpedi.2020.10.017
Resumen Introducción: El seguimiento telefónico es una posible alternativa para la atención médica de niños con COVID-19. Nuestro objetivo es describir la experiencia del seguimiento telemático realizado en un hospital terciario. Pacientes y métodos: Estudio descriptivo retrospectivo de los niños con diagnóstico confirmado o probable de COVID-19 atendidos en la consulta de seguimiento del Hospital La Paz entre marzo y junio del 2020. Se realizaron llamadas cada 48 h hasta desaparecer los síntomas y posteriormente semanales hasta estar 14 días asintomáticos. Resultados: Se incluyó a 72 niños con una mediana de edad de 83,5 meses (RIC = 16,3-157,5); 46 eran varones (63,9%) y 14 tenían comorbilidades (19,4%); 32 pacientes (44,4%) habían requerido ingreso hospitalario. Se confirmó diagnóstico de COVID-19 en 33 niños por PCR y en 7 por serología. De los confirmados por PCR, seroconvirtió el 67,7%. Se demostraron otras etiologías en 7 pacientes (5 Mycoplasma pneumoniae, uno parvovirus y uno citomegalovirus). La mediana de duración de síntomas fue 25,5 días (RIC = 13,8-37), con mediana de tiempo de seguimiento de 28 días (RIC = 21-39). Se realizó una mediana de 6 llamadas (RIC = 4-8) por niño; 19 pacientes (26,4%) refirieron empeoramiento en el seguimiento, precisando 14 (19,4%) ser revaluados en Urgencias. Un niño necesitó reingresar, siendo la evolución favorable.
References
Bastos, Tavaziva, Abidi, Campbell, Haraoui et al., Diagnostic accuracy of serological tests for covid-19: Systematic review and meta-analysis, BMJ
Bwire, Majigo, Njiro, Mawazo, Detection profile of SARS-CoV-2 using RT-PCR in different types of clinical specimens: A systematic review and meta-analysis, J Med Virol,
doi:10.1002/jmv.26349
Cavalcanti, Zampieri, Rosa, Azevedo, Veiga et al., Hydroxychloroquine with or without azithromycin in mild-to-moderate Covid-19, N Engl J Med,
doi:10.1056/NEJMoa2019014
Colmenero, Santonja, Alonso-Riaño, Noguera-Morel, Hernández-Martín et al., SARS-CoV-2 endothelial infection causes COVID-19 chilblains: Histopathological, immunohistochemical and ultraestructural study of 7 paediatric cases, Br J Dermatol,
doi:10.1111/bjd.19327
Dong, Mo, Hu, Qi, Jiang et al., Epidemiology of COVID-19 among children in China, Pediatrics
Gallais, Velay, Wendling, Nazon, Partisani et al., Intrafamilial Exposure to SARS-CoV-2 induces cellular immune response without seroconversion, medRxiv
Gottlieb, Long, Dermatologic manifestations and complications of COVID-19, Am J Emerg Med
Guessoum, Lachal, Radjack, Carretier, Minassian et al., Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown, Psychiatry Res
Götzinger, Santiago-García, Noguera-Julián, Lanaspa, Lancella et al., COVID-19 in children and adolescents in Europe: A multinational, multicentre cohort study, Lancet Child Adolesc Health
Hoang, Chorath, Moreira, Evans, Burmeister-Morton et al., COVID-19 in 7780 pediatric patients: A systematic review, EClinicalMedicine
Li, Yao, Li, Chen, Song et al., Stability issues of RT-PCR testing of SARS-CoV-2 for hospitalized patients clinically diagnosed with COVID-19, J Med Virol,
doi:10.1002/jmv.26349
Meng, Deng, Dai, Meng, COVID-19 and anosmia: A review based on up-to-date knowledge, Am J Otolaryn
Otto, Geoghegan, Posch, Bell, Coffin et al., The epidemiology of SARS-CoV-2 in a Pediatric Healthcare Network in the United States, J Pediatric Infect Dis Soc
Pollán, Pérez-Gómez, Pastor-Barriuso, Oteo, Hernán et al., Prevalence of SARS-CoV-2 in Spain (ENE-COVID): A nationwide, population-based seroepidemiological study, Lancet
Poncet-Megemont, Paris, Tronchere, Salazard, Pereira et al., High prevalence of headaches during Covid-19 infection: A retrospective cohort study, Headache,
doi:10.1111/head.13923
Recovery Collaborative Group, Horby, Mafham, Linsell, Bell et al., Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19, N Engl J Med
Rosenberg, Dufort, Udo, Wilberschied, Kumar et al., Association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with COVID-19 in New York State, JAMA
Sekine, Perez-Potti, Rivera-Ballesteros, Strålin, Gorin et al., Robust T cell immunity in convalescent individuals with asymptomatic or mild COVID-19, Cell
Spinato, Fabbris, Polesel, Cazzador, Borsetto et al., Alterations in smell or taste in mildly symptomatic outpatients with SARS-CoV-2 infection, JAMA
Tenforde, Kim, Lindsell, Rose, Shapiro et al., Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a Multistate Health Care Systems Network-United States, MMWR Morb Mortal Wkly Rep
Wajnberg, Mansour, Leven, Bouvier, Patel et al., Humoral response and PCR positivity in patients with COVID-19 in the New York City region, USA: an observational study, Lancet Microbe
Walsh, Jordan, Clyne, Rohde, Drummond et al., SARS-CoV-2 detection, viral load and infectivity over the course of an infection, J Infect
Who Director, General's opening remarks at the media briefing on COVID-19
Who Director, General's opening remarks at the media briefing on COVID-19. 13
Wikramaratna, Paton, Ghafari, Lourenco, Estimating false-negative detection rate of SARS-CoV-2 by RT-PCR
Younes, Al-Sadeq, Al-Jighefee, Younes, Al-Jamal et al., Challenges in laboratory diagnosis of the novel coronavirus SARS-CoV-2, Viruses
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'article-title': 'Epidemiology of COVID-19 among children in China',
'volume': '145',
'author': 'Dong',
'year': '2020',
'journal-title': 'Pediatrics.'},
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'article-title': 'The epidemiology of SARS-CoV-2 in a Pediatric Healthcare Network in the '
'United States',
'volume': 'piaa074',
'author': 'Otto',
'year': '2020',
'journal-title': 'J Pediatric Infect Dis Soc.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0185',
'first-page': '30177',
'article-title': 'COVID-19 in children and adolescents in Europe: A multinational, '
'multicentre cohort study',
'volume': 'S2352–4642',
'author': 'Götzinger',
'year': '2020',
'journal-title': 'Lancet Child Adolesc Health.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0190',
'unstructured': 'Actualización n.° 174. Enfermedad por el coronavirus (COVID-19). 30 de '
'julio del 2020. Centro de Coordinación de Alertas y Emergencias '
'Sanitarias. Dirección General de Salud Pública. Ministerio de Sanidad de '
'España [Fecha de consulta 07 Jul 2020]. Disponible en: '
'https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/Actualizacion_174_COVID-19.pdf'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0195',
'unstructured': 'Comunicado reorganización de la atención pediátrica urgente. 21 de marzo '
'del 2020. Consejería de Sanidad de la Comunidad de Madrid. Disponible '
'en: '
'https://www.comunidad.madrid/sites/default/files/doc/sanidad/comu/200321_comunicado_sanidad_coronavirus_centros_urgencias_atencion_pediatrica_0.pdf'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0200',
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'SARS-CoV-2. AEP-SEIP-SEUP-SECIP [actualizado 24 Mayo 2020] [Fecha de '
'consulta 07 Jul 2020]. Disponible en: '
'https://www.aeped.es/sites/default/files/24_5-_aep-seip-secip-seup._document_o_de_manejo_clinico_del_paciente_pediaitrico_-_extracto_del_documento_del_ministerio_propuestas_1.pdf'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0205',
'unstructured': 'Manejo pediátrico en atención primaria del COVID-19. Versión del 18 de '
'junio de 2020. Centro de Coordinación de Alertas y Emergencias '
'Sanitarias. Dirección General de Salud Pública. Ministerio de Sanidad de '
'España [Fecha de consulta 07 Jul 2020]. Disponible en: '
'https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/Manejo_pediatria_ap.pdf'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0210',
'unstructured': 'COVID-19 Treatment guidelines panel. Coronavirus disease 2019 (COVID-19) '
'treatment guidelines. National Institutes of Health [Fecha de consulta '
'07 Jul 2020]. Disponible en '
'https://www.covid19treatmentguidelines.nih.gov/'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0215',
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'related to COVID-19. 15 May 2020 Scientific Brief: World Health '
'Organization [Fecha de consulta 07 Jul 2020]. Disponible en: '
'https://www.who.int/news-room/commentaries/detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0220',
'doi-asserted-by': 'crossref',
'first-page': '100433',
'DOI': '10.1016/j.eclinm.2020.100433',
'article-title': 'COVID-19 in 7780 pediatric patients: A systematic review',
'volume': '24',
'author': 'Hoang',
'year': '2020',
'journal-title': 'EClinicalMedicine.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0225',
'doi-asserted-by': 'crossref',
'DOI': '10.1111/bjd.19327',
'article-title': 'SARS-CoV-2 endothelial infection causes COVID-19 chilblains: '
'Histopathological, immunohistochemical and ultraestructural study of 7 '
'paediatric cases',
'author': 'Colmenero',
'year': '2020',
'journal-title': 'Br J Dermatol.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0230',
'doi-asserted-by': 'crossref',
'first-page': '1715',
'DOI': '10.1016/j.ajem.2020.06.011',
'article-title': 'Dermatologic manifestations and complications of COVID-19',
'volume': '38',
'author': 'Gottlieb',
'year': '2020',
'journal-title': 'Am J Emerg Med.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0235',
'doi-asserted-by': 'crossref',
'first-page': '102581',
'DOI': '10.1016/j.amjoto.2020.102581',
'article-title': 'COVID-19 and anosmia: A review based on up-to-date knowledge',
'volume': '41',
'author': 'Meng',
'year': '2020',
'journal-title': 'Am J Otolaryngol.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0240',
'doi-asserted-by': 'crossref',
'first-page': '2089',
'DOI': '10.1001/jama.2020.6771',
'article-title': 'Alterations in smell or taste in mildly symptomatic outpatients with '
'SARS-CoV-2 infection',
'volume': '323',
'author': 'Spinato',
'year': '2020',
'journal-title': 'JAMA.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0245',
'doi-asserted-by': 'crossref',
'first-page': '113264',
'DOI': '10.1016/j.psychres.2020.113264',
'article-title': 'Adolescent psychiatric disorders during the COVID-19 pandemic and '
'lockdown',
'volume': '291',
'author': 'Guessoum',
'year': '2020',
'journal-title': 'Psychiatry Res.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0250',
'doi-asserted-by': 'crossref',
'first-page': '993',
'DOI': '10.15585/mmwr.mm6930e1',
'article-title': 'Symptom duration and risk factors for delayed return to usual health '
'among outpatients with COVID-19 in a Multistate Health Care Systems '
'Network-United States',
'volume': '69',
'author': 'Tenforde',
'year': '2020',
'journal-title': 'MMWR Morb Mortal Wkly Rep.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0255',
'doi-asserted-by': 'crossref',
'DOI': '10.1111/head.13923',
'article-title': 'High prevalence of headaches during Covid-19 infection: A retrospective '
'cohort study',
'author': 'Poncet-Megemont',
'year': '2020',
'journal-title': 'Headache.'},
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'article-title': 'SARS-CoV-2 detection, viral load and infectivity over the course of an '
'infection',
'volume': 'S0163-4453',
'author': 'Walsh',
'year': '2020',
'journal-title': 'J Infect.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0265',
'article-title': 'Estimating false-negative detection rate of SARS-CoV-2 by RT-PCR',
'author': 'Wikramaratna',
'year': '2020',
'journal-title': 'medRxiv.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0270',
'article-title': 'Detection profile of SARS-CoV-2 using RT-PCR in different types of '
'clinical specimens: A systematic review and meta-analysis',
'author': 'Bwire',
'year': '2020',
'journal-title': 'J Med Virol.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0275',
'doi-asserted-by': 'crossref',
'first-page': '903',
'DOI': '10.1002/jmv.25786',
'article-title': 'Stability issues of RT-PCR testing of SARS-CoV-2 for hospitalized '
'patients clinically diagnosed with COVID-19',
'volume': '92',
'author': 'Li',
'year': '2020',
'journal-title': 'J Med Virol.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0280',
'doi-asserted-by': 'crossref',
'first-page': '582',
'DOI': '10.3390/v12060582',
'article-title': 'Challenges in laboratory diagnosis of the novel coronavirus SARS-CoV-2',
'volume': '12',
'author': 'Younes',
'year': '2020',
'journal-title': 'Viruses.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0285',
'doi-asserted-by': 'crossref',
'first-page': 'm2516',
'DOI': '10.1136/bmj.m2516',
'article-title': 'Diagnostic accuracy of serological tests for covid-19: Systematic '
'review and meta-analysis',
'volume': '370',
'author': 'Lisboa Bastos',
'year': '2020',
'journal-title': 'BMJ.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0290',
'first-page': '31483',
'article-title': 'Prevalence of SARS-CoV-2 in Spain (ENE-COVID): A nationwide, '
'population-based seroepidemiological study',
'volume': 'S0140-6736',
'author': 'Pollán',
'year': '2020',
'journal-title': 'Lancet.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0295',
'doi-asserted-by': 'crossref',
'first-page': 'e283',
'DOI': '10.1016/S2666-5247(20)30120-8',
'article-title': 'Humoral response and PCR positivity in patients with COVID-19 in the '
'New York City region, USA: an observational study',
'volume': '1(7)',
'author': 'Wajnberg',
'year': '2020',
'journal-title': 'Lancet Microbe.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0300',
'doi-asserted-by': 'crossref',
'first-page': '158',
'DOI': '10.1016/j.cell.2020.08.017',
'article-title': 'Robust T cell immunity in convalescent individuals with asymptomatic or '
'mild COVID-19',
'volume': '183(1)',
'author': 'Sekine',
'year': '2020',
'journal-title': 'Cell.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0305',
'article-title': 'Intrafamilial Exposure to SARS-CoV-2 induces cellular immune response '
'without seroconversion',
'author': 'Gallais',
'year': '2020',
'journal-title': 'medRxiv.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0310',
'doi-asserted-by': 'crossref',
'first-page': '2493',
'DOI': '10.1001/jama.2020.8630',
'article-title': 'Association of treatment with hydroxychloroquine or azithromycin with '
'in-hospital mortality in patients with COVID-19 in New York State',
'volume': '323',
'author': 'Rosenberg',
'year': '2020',
'journal-title': 'JAMA.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0315',
'doi-asserted-by': 'crossref',
'first-page': '2041',
'DOI': '10.1056/NEJMoa2019014',
'article-title': 'Hydroxychloroquine with or without azithromycin in mild-to-moderate '
'Covid-19',
'volume': '383(21)',
'author': 'Cavalcanti',
'year': '2020',
'journal-title': 'N Engl J Med.'},
{ 'key': '10.1016/j.anpedi.2020.10.017_bib0320',
'doi-asserted-by': 'crossref',
'unstructured': 'RECOVERY Collaborative Group, Horby P, Mafham M, Linsell L, Bell JL, '
'Staplin N, Emberson JR, et al. Effect of Hydroxychloroquine in '
'Hospitalized Patients with Covid-19. N Engl J Med. 2020 Nov '
'19;383(21):2030-2040.',
'DOI': '10.1056/NEJMoa2022926'}],
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