To explore effect and safety of multi-disciplinary team (MDT) based on prevention and control management mode under online (PCM-online) in outpatient follow-up of children with Kawasaki disease and complicated with coronary artery lesion (CAL) during the epidemic outbreak period of corona virus disease 2019 (COVID-19).

From 21 January, 2020 to 19 February, 2020, a total of 35 children with Kawasaki disease and complicated with CAL who received long-term treatment in the Department of Cardiovascular of Chengdu Women′s and Children′s Central Hospital and needed to go to the hospital for referral during epidemic outbreak period were selected as research subjects. By setting up an MDT based on PCM-online covering medical care, nursing, cardiac ultrasound, pharmacy, nutrition and psychology, and adopting the " Internet + " method, online consultations were provided to children with Kawasaki disease and complicated with CAL who needed to go to the hospital for referral, such as professional consultation of Kawasaki disease with CAL, psychological intervention, guidance on medication, nutrition diet and home care, and health education of COVID-19 and guidance on protective measures when going out for medical treatment. For some family members of children with relatively tense and anxious emotions, the Symptom Checklist 90 (SCL-90) was used for psychological evaluation, and online psychological counseling was conducted based on the psychological evaluation results. A self-made satisfaction questionnaire of our hospital was used to investigate the satisfaction of family members of children before and after intervention of MDT based on PCM-online. The scores of SCL-90 factors and satisfaction scores of family members of the children before and after intervention of MDT based on PCM-online were compared by paired t test. The procedures followed in this study were in accordance with the requirements of newly revised World Medical Association Declaration of Helsinki in 2013.

①Among the 35 children with Kawasaki disease and complicated with CAL, 26 children canceled on-site outpatient visits after intervention of MDT based on PCM-online, thus avoiding the risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at least 52 people going out for medical treatment; 9 patients required on-site follow-up due to their pathogenetic conditions. ②A total of 11 cases of family members of children received SCL-90 for psychological evaluation by mental intervention subgroup in MDT, and all of them were with positive results. After receiving psychological counseling in mental intervention subgroup, anxiety and fear factor scores in SCL-90 of the family members of these 11 children were (1.38±0.44) scores and (1.23±0.42) scores, respectively, which were higher than those before receiving psychological counseling (1.64±0.25) scores and (1.38±0.13) scores, and both the differences were statistically significant (t=3.285, 2.853; P=0.010, 0.024). ③After intervention of MDT based on PCM-online, the satisfaction score of 35 children′s family members was (98.6±1.4) scores, which was significantly higher than (94.3±4.7) scores before intervention, and the difference was statistically significant (t=4.369, P=0.031).

During COVID-19 epidemic period, intervention of MDT based on PCM-online achieves the purpose of epidemic prevention and control of COVID-19 and promotes the recovery of children with Kawasaki disease and complicated with CAL which is a new model for prevention and control of COVID-19 with low-risk, low-cost and high-efficiency under severe epidemic situation. Due to the relatively small sample-size and relatively short period of time enrolled in this study, whether this model is worthy of clinical popularization and application remains to be further studied and confirmed.