Study shows children with COVID-19 can be safely cared for at home

Children with COVID-19 can be safely treated at home, and the majority avoid hospitalisation altogether, according to a study by Murdoch Children’s Research Institute.

The research, led by Murdoch Children’s Research Institute (MCRI) and published in Archives of Disease in Childhood, found COVID-positive children with moderate symptoms or pre-existing high-risk conditions were treated effectively via the Royal Children’s Hospital Hospital-in-the-Home (HITH) program. 

The study looked at all children admitted to the HITH program – referred by The Royal Children’s Hospital or the Victorian Department of Health – from March 2020 to March 2022. 

Of 3,719 children in the HITH program, 421 aged 0-18 years had COVID-19. Of those, 16 had the original strain of COVID-19, 154 had Delta and 251 had Omicron.

Sixty-three percent of COVID-19-positive children in the program were high risk and 33 per cent were moderately unwell. 

While the HITH program was untested for managing COVID-19 at the start of 2020, only 10 per cent of COVID-19-positive children were readmitted to hospital, with just 5 per cent needing medical intervention (such as oxygen).

As part of the HITH program, patients were assessed in person or via telehealth by a doctor or nurse up to three times daily. They were also supported by in-home monitoring (such as oximeters, scales, thermometers) and a symptom tracker. Patients were re-assessed in the case of deterioration. 

With no published guidance on which children would benefit most from home-based management of COVID-19 at the start of the pandemic, MCRI developed a ‘traffic light guideline’ based on symptoms and clinical features to assist decisions.

MCRI’s Dr Laila Ibrahim says the program took pressure off paediatric emergency departments and helped reduce COVID-19 transmission in hospital during the first two years of the pandemic.

Children do better if it’s possible to manage them at home and the infectious nature of SARS-CoV-2 increased the imperative to try to keep children out of hospital,” she says.

The paper says “for COVID-19-positive children, there are additional benefits to being out of hospital, where safety prioritisation means visiting restrictions and children confined to rooms”. 

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