Children's Doctor News Spring 2021

CHOP and Geisinger announce affiliation agreement

Geisinger Janet Weis Children’s Hospital and Children’s Hospital of Philadelphia announced an affiliation agreement that will increase access to and further advance the delivery of pediatric healthcare to families in central and northeast Pennsylvania. The affiliation seeks to leverage the combined expertise and infrastructure of both organizations, ensuring that children in the region receive the right care, at the right time, in the right place, delivered by the best clinical team to meet their medical needs.

The affiliation will initially focus on increasing access in quaternary care, then will expand to include several distinct agreements spanning the spectrum of pediatric disorders. The alliance will provide access to CHOP’s expertise in rare and complex diseases, while harnessing Geisinger’s well-established outpatient general and specialty pediatric programs and inpatient services at Janet Weis Children’s Hospital.

No difference in concussion recovery time between male and female athletes

Female and male collegiate athletes take approximately the same amount of time (13.5 days and 11.8 days, respectively) to recover from a concussion, with subtle differences in recovery time depending on the type of sports being played and the division level of the sport, according to a CARES Consortium study with CHOP lead authors. Equity in access to sports medical care among college athletes may be contributing to these similar outcomes.

Data on thousands of collegiate athletes came from the CARE (Concussion Assessment, Research and Education) Consortium. Findings were published by the British Journal of Sports Medicine.

Focused effort boosts rate of HPV vaccinations

Primary Care offices in the CHOP Care Network boosted their rate of HPV vaccinations by 15% to 50% after launching a quality improvement effort. The interventions consisted of making the vaccine opt-out vs. opt-in; sending physicians vaccine data regularly; making HPV-focused education easily accessible online and via podcast; and instituting standing orders for all HPV doses.

“By engaging our providers and prioritizing HPV vaccination, we were able to increase the number of patients receiving this important vaccine,” says Elena Huang, MD, project leader for the improvement program.

Two CHOP studies add to understanding of MIS-C

Diagnosing multi-system inflammatory syndrome in children (MIS-C), the post-infectious complication of SARS-CoV-2 infection, has posed challenges, as many of its symptoms, including rash, are common in many other pediatric infections.

In Open Forum Infectious Diseases, CHOP researchers describe the array of rashes seen in their MIS-C patients through late July 2020, providing photos and information that could help doctors diagnose future cases.

“We hope the information provided in this research letter will help general pediatricians and emergency department physicians who may wonder if a patient with a fever requires a more extensive examination,” said Audrey Odom John, MD, PhD, Chief, Division of Pediatric Infectious Diseases and senior author of the paper.

Researchers also have found that children with MIS-C have highly activated immune systems that, in many ways, are more similar to those of adults with severe COVID-19.

“This study shows that children with MIS-C are tremendously immune activated, particularly when it comes to CD8 T cells, but that this activation subsides once patients begin to improve clinically,” says first author Laura Vella, MD, PhD. “Our findings provide a broad immunologic foundation for understanding pathogenesis and recovery in this novel SARS-CoV-2- associated inflammatory syndrome, with potential implications for adult disease.”

The study was published in Science Immunology.

CHOP’s clinical pathway for MIS-C is updated when new information becomes available and can be found at chop.edu/misc-pathway.