A Comprehensive Clinical Description of Pediatric SARS-CoV-2 Infection in Western Pennsylvania

Objective: We sought to characterize clinical presentation and healthcare utilization for pediatric COVID-19 in Western Pennsylvania (PA). Methods: We established and analyzed a registry of pediatric COVID-19 in Western PA that includes cases in patients <22 years of age cared for by the pediatric quaternary medical center in the area and its associated pediatric primary care network from March 11 through August 20, 2020. Results: Our cohort included 424 pediatric COVID-19 cases (mean age 12.5 years, 47.4% female); 65% reported exposure and 79% presented with symptoms. The most common initial healthcare contact was through telehealth (45%). Most cases were followed as outpatients, but twenty-two patients (4.5%) were hospitalized: 19 with acute COVID-19 disease, and three for multisystem inflammatory syndrome of children (MIS-C). Admitted patients were younger (p<0.001) and more likely to have pre-existing conditions (p<0.001). Black/Hispanic patients were 5.8 times more likely to be hospitalized than white patients (p=0.012). Five patients (1.2%) were admitted to the PICU, including all three MIS-C cases; two required BiPAP and one mechanical ventilation. All patients survived. Conclusions: We provide a comprehensive snapshot of pediatric COVID-19 disease in an area with low to moderate incidence. In this cohort, COVID-19 was generally a mild disease; however, ~5% of children were hospitalized. Pediatric patients can be critically ill with this infection, including those presenting with MIS-C.

Download Full-text

Contraceptive counseling among pediatric primary care providers in Western Pennsylvania: A survey-based study

SAGE Open Medicine ◽

10.1177/2050312117730244 ◽

2017 ◽

Vol 5 ◽

pp. 205031211773024 ◽

Cited By ~ 2

Author(s):

Beth Ann Papas ◽

Nader Shaikh ◽

Katherine Watson ◽

Gina S Sucato

Keyword(s):

Primary Care ◽

Primary Care Providers ◽

Pediatric Primary Care ◽

Care Providers ◽

Contraceptive Counseling ◽

Western Pennsylvania

Download Full-text

The Challenging Diagnosis of Pediatric Multisystem Inflammatory Syndrome Associated with Sars-Cov-2 Infection—Two Case Reports and Literature Review

Journal of Personalized Medicine ◽

10.3390/jpm11040318 ◽

2021 ◽

Vol 11 (4) ◽

pp. 318

Author(s):

Marcela Daniela Ionescu ◽

Roxana Taras ◽

Bianca Dombici ◽

Mihaela Balgradean ◽

Elena Camelia Berghea ◽

...

Keyword(s):

High Risk ◽

Kawasaki Disease ◽

Pediatric Patients ◽

Clinical Presentation ◽

Case Reports ◽

Cardiovascular Complications ◽

Novel Coronavirus ◽

Short Time ◽

Respiratory Coronavirus ◽

Inflammatory Syndrome

Severe acute respiratory coronavirus 2 (SARS-CoV-2) is a novel coronavirus discovered in 2019 that caused the coronavirus disease 2019 (COVID19). During the last year, over 70 million people were infected and more than 1.5 million people died. Despite the tremendous number of people infected, children were less affected and presented milder forms of the disease. A short time after the pandemic was declared, a new hyperinflammatory syndrome resembling Kawasaki disease (KD) was described in children with confirmed or suspected SARS-CoV-2 infection named multisystem inflammatory syndrome in children (MIS-C). The incidence of MIS-C is low and it has a polymorphous clinical presentation, making the diagnosis difficult. Although the incidence is reduced, there is a high risk of cardiovascular complications. In order to raise awareness, we present the cases of two pediatric patients diagnosed with MIS-C in our clinic.

Download Full-text

Clinical Presentation of Celiac Disease in Hispanic Patients Presenting to an Urban Medical Center

The American Journal of Gastroenterology ◽

10.14309/00000434-201410002-00359 ◽

2014 ◽

Vol 109 ◽

pp. S108

Author(s):

Mark Salem ◽

Nirupama Bonthala ◽

Andrea Cedeno ◽

Priscilla Campos ◽

Caroline Hwang ◽

...

Keyword(s):

Celiac Disease ◽

Clinical Presentation ◽

Medical Center ◽

Hispanic Patients

Download Full-text

Pediatric primary care and subspecialist providers’ comfort, attitudes and practices screening and referring for social determinants of health

BMC Health Services Research ◽

10.1186/s12913-021-06975-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yonit Lax ◽

Eleanor Bathory ◽

Sandra Braganza

Keyword(s):

Primary Care ◽

Low Income ◽

Primary Care Physicians ◽

Medical Center ◽

Academic Medical Center ◽

Primary Care Providers ◽

Pediatric Primary Care ◽

Care Providers ◽

Low Income Children ◽

Academic Medical

Abstract Background Early detection and management of poverty-related disorders is a recommended pediatric practice; however, little is known about variations of practice between pediatric primary care physicians and subspecialists. The objectives of this study were to assess (1) provider perceptions and attitudes toward caring for low-income children in an urban academic medical center, and (2) variations between primary care physicians and subspecialists in social and financial needs screening and referral practices for low-income children. Design/Methods Primary care providers (pediatric and family medicine) and subspecialists providing direct patient care in an urban academic medical center (response rate = 24 %, n = 85/356) completed a 24-item survey (adapted with permission from the AAP Periodic Survey of Fellows No.90) assessing feasibility and comfort screening and addressing social and financial needs, rates of screening for financial hardship, and referrals to local resources. Chi-square tests were performed. Results Among respondents, 88 % (75/85) reported comfort caring for low-income children, while 28 % (24/85) reported comfort inquiring about social and financial needs and 34 % (29/85) referring to community resources. Primary care providers more commonly than subspecialists screened for childcare (80 % vs. 59 %, p = 0.04), parental: employment (84 % vs. 59 %, p = 0.01), education (40 % vs. 17 %, p = 0.02) and mental health (86 % vs. 46 %, p = 0.0001), and less commonly screened for transportation (47 % vs. 73 %, p = 0.01). Primary care providers more commonly referred for public health insurance (74 % vs. 39 %, p = 0.001), public food assistance (30 % vs. 12 %, p = 0.04), and adult mental health services (65 % vs. 44 %, p < 0.05). Conclusions In an urban academic institution serving a population with high poverty rates, pediatric providers feel comfortable providing medical care for low-income children but lack comfort screening and addressing SDH. Though most feel it is their job to refer to resources, less than half felt it was feasible to screen for or address financial needs. Pediatric primary care providers report higher rates of screening and referring than subspecialists. Understanding variations in practice and perceptions among primary care providers and subspecialists may aid in creating interventions to increase screening and referral rates.

Download Full-text