COVID-19 Outbreak Among Adolescents at an Inpatient Behavioral Health Hospital

Purpose: We report on a coronavirus disease 2019 (COVID-19) outbreak among adolescents at an inpatient behavioral health facility that was identified within 5 weeks of known viral transmission in the surrounding community. Methods: Clinical records were reviewed for all inpatients aged <18 years with laboratory confirmed COVID-19 between March 23 and April 21, 2020. Results: A total of 19 COVID-19-positive patients aged 11-17 years were identified. Patients most commonly presented with sore throat (37%) and nausea/vomiting (32%). Only 26% of patients presented with cough, shortness of breath, or fever. The most common medical comorbidity was asthma (32%), and the most common psychiatric comorbidity was posttraumatic stress disorder (63%). Infected patients were colocated and managed together on a separate COVID-19 unit to maintain a therapeutic group milieu. Mental health treatment was modified to limit staff exposure. Patients received daily medical assessment by an in-house pediatrician. One patient required intravenous fluids. No patients required transfer to a medical facility. Conclusions: Adolescents in psychiatric inpatient settings may be especially vulnerable to COVID-19 infection. Close collaboration between medical and psychiatric care providers is needed to optimize care for this population and to address admission and disposition options for infected patients. (C) 2020 Society for Adolescent Health and Medicine. All rights reserved.