The Impact Of SARS-CoV-2 Pandemic On Paediatric Follow-up of a Northern Portugal Tertiary Hospital

The SARS-CoV-2 outbreak required considerable changes to hospital daily routine. In-person appointments were called into question and consequently the outpatient follow-up. From this need of adaptation, telemedicine grew, allowing to mitigate the impact of this crisis on the patient with chronic pathology.

We aimed to understand the impact that the SARS-CoV-2 pandemic had on the follow-up of paediatric patients.

Retrospective analysis of paediatric appointments (general and subspecialties) in the first semester of 2019 and 2020.

In the first half of 2019, 19555 medical paediatric appointments were carried out. Only 22 of those were remote. First visits were 4135, all in-person. In the same period of 2020, 20182 appointments took place and 8202 were remote. First visits were 3544 and 598 of those were remote. There was a decrease of 38.7% in in-person appointments and 28.8% reduction in in-person first visits between the first semester of 2019 and 2020. All subspecialties changed from virtually 100% in-person follow-up to a remote follow-up ranging between 3.17% (Gastroenterology in June) and 100% (Neurology in April) depending on the month. It was created a new exclusively remote follow-up to track SARS-CoV-2 infected patients responsible for 141 first and 709 subsequent visits.

Paediatricians saw their daily clinical practice undergo a major change overnight. The chronic patient could not be left without follow-up but getting the patients to go to the hospital would be unwise. Remote appointments came to fill a potential flaw that could become serious. Through telemedicine we were able to ascertain the health status of the patients and only refer those in need for in-person medical visit, reducing the interaction between professionals and patients that could increase the spread of the virus. This crisis was a catalyst for innovation in the practice of medicine and certainly will change the management of the outpatient.