Kids with covid can be treated safely at home

A hospital-in-the-home program using remote monitoring makes the patients happier and reduces transmission.

---

Covid-positive children with moderate symptoms or pre-existing high-risk conditions can be effectively managed at home without the risk of complications, a recent study from the Murdoch Children’s Research Institute has found.

Assessing patient outcomes for 3700 children treated via the Melbourne Royal Children Hospital’s Hospital-in-the-Home program between 2020 and 2022, researchers found that that only 10% of the 400 covid-positive children were readmitted to hospital.

Of the 40 children readmitted to hospital, none deteriorated rapidly and only two required medical intervention after readmission.

All covid patients were assessed by a doctor or nurse, either in-person or remotely, one to three times daily, with parents tracking their child’s symptoms through a digital patient portal.

Among the 400 children with covid managed at home, 130 had moderately severe symptoms and 250 were considered high-risk with one or more pre-existing conditions.

The results clearly demonstrate how the Hospital-in-the-Home program reduced covid transmission and alleviated pressure for paediatric emergency departments, Murdoch Children’s Clinical-Scientist Fellow Dr Laila Ibrahim told media.

“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,” Dr Ibrahim, who was not involved in the study, said.

“These findings reassure us that care at home has been safe and effective regardless of covid strain and this takes the burden off inpatient care.”

Overall, the number of covid and non-covid patients treated through the Hospital-in-the-Home program rose by 21% during the first two years of the pandemic.  

The authors also observed a 132% increase in the number of telehealth appointments conducted between 2020 and 2022, compared to pre-pandemic levels.

The Royal Children’s Hospital Hospital-in-the-Home program provides statewide paediatric acute care at home that would typically require hospital admission, including frequent monitoring of vital signs, clinical assessment of respiratory or hydration status and interventions such as intravenous antibiotics.

Associate Professor Penelope Bryant, lead author of the study, told media that programs offering acute home management were becoming an increasingly vital alternative to hospitalisation even before the pandemic.

“The benefits of being treated in the home care include improved child quality of life, higher parent satisfaction and avoidance of hospital-acquired infections,” she said.

“We advocate that where possible children should be cared for at home rather than hospital, knowing the severe impact of the pandemic on children’s mental health.”

Archives of Disease in Childhood 2023, online 24 February.