Balancing Risks in the Time of COVID-19

Kimberlin, David W.; Puopolo, Karen M.

doi:10.1001/jamapediatrics.2020.4304

Cited by 5 publications

(3 citation statements)

References 12 publications

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“…Current evidence suggests that it is probable that perinatal transmission could occur in 1–2% of neonates born to mothers with SARS-CoV-2 infection. However, the likelihood of perinatal transmission is very low [ 19 ].…”

Section: Covid Pandemic and Maternal–infant Healthmentioning

confidence: 99%

Supporting Breastfeeding in 2021 and Beyond—Lessons from the Pandemic

2021

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The COVID-19 pandemic has affected maternal and infant health globally both directly from infection with the SARS-CoV-2 virus and indirectly from changes in health care resulting from social, economic, and health care policies unique to each country. The developing countries have to share the disproportionate burden on maternal and infant health. In this review, we discuss the uncertainties resulting from SARS-CoV-2 infection in pregnancy, vertical transmission of the virus, and its effects on breastfeeding of the newborn. The problems of families and communities caring for mothers with COVID-19 and its impact on breastfeeding in newborns are discussed. The challenges posed by the pandemic have forced us to think and devise innovative solutions, including telemedicine help for antenatal counseling, breastfeeding education, and lactation support. Optimal utilization of resources and technology to find creative solutions at the individual and the community level will help in facilitating maternal–infant bonding soon after birth. Appropriate health care policies to support pregnant and lactating mothers will go a long way in meeting healthy child development goals.

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Section: Covid Pandemic and Maternal–infant Healthmentioning

confidence: 99%

Supporting Breastfeeding in 2021 and Beyond—Lessons from the Pandemic

2021

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“…In a large study of 101 newborns born to Covid-19-positive mothers, no evidence of perinatal transmission was observed, despite two infants having results demonstrating low viral loads [19]. Current evidence suggests that the likelihood of perinatal transmission of SARS-CoV-2 is very low [20]. Despite the weight of the evidence demonstrating the lack of in utero transmission of SARS-CoV-2, the expression of angiotensin-converting enzyme 2 (ACE2), the receptor for SARS-CoV-2, on maternal-fetal interface cells such as stromal cells, cytotrophoblasts, and syncytiotrophoblasts on the placenta and other fetal organs [21] may suggest that vertical transmission is possible and needs to be investigated further.…”

Section: Discussionmentioning

confidence: 93%

Respiratory Failure in an Extremely Premature Neonate with COVID-19

et al. 2021

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Coronavirus disease 2019 (COVID-19), a condition associated with SARS-CoV-2, typically results in mild infection in infants and children. However, children with risk factors such as chronic lung disease and immunosuppression have higher risk of severe illness from COVID-19. We report a case of a 27-week-gestation extremely premature infant born to a mother with COVID-19 infection. The infant, initially treated for surfactant deficiency, developed worsening hypoxic respiratory failure on the fifth day of life requiring escalating ventilatory support, an elevated level of C-reactive protein, thrombocytopenia, and an elevated level of d-dimer. The infant was positive for SARS-CoV-2 by RT-PCR from Day 1 to Day 42 of his life. The infant responded to a seven-day course of dexamethasone with a gradually decreasing oxygen requirement and could be extubated to non-invasive ventilation by the end of the fifth week after birth. The infant is currently on home oxygen by nasal cannula. Prolonged shedding of the virus may be a unique feature of the disease in premature infants. Extreme prematurity, immature lungs, and an immunocompromised status may predispose these infants to severe respiratory failure and a prolonged clinical course. Instituting appropriate COVID-19 protocols to prevent the spread of the disease in the neonatal intensive care unit (NICU) is of utmost importance. Infection with SARS-CoV-2 may have implications in the management of extremely premature infants in the NICU.

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“…Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an RNA virus, has undergone a series of mutations and evolutions, giving rise to various variants and subvariants with strong infectious and immune escape ability, which makes coronavirus disease 2019 (COVID-19) a global pandemic that has a devastating impact on individuals and multiple aspects of our society [ 1 – 3 ]. On Nov, 2021, a highly mutated SARS-CoV-2 variant, Omicron (B.1.1.529), was first detected in South Africa and has rapidly spread worldwide [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of abruptly increased paediatric patients with Omicron BF.7 or BA.5.2 in Beijing

Yu,

Wang,

et al. 2023

Virol J

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Background The coronavirus disease 2019 outbreak has hit Beijing since mid-Nov, 2022, with soaring growth of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children. Therefore, it is vital to determine the clinical manifestations of epidemic SARS-CoV-2 strains in paediatric patients. Methods In this study, nucleic acid tests (NATs) for SARS-CoV-2 were performed in paediatric outpatients with symptoms of acute respiratory tract infection during 18 Nov–6 Dec, 2022. Half of the outpatients positive for SARS-CoV-2 were randomly selected to screen for other respiratory pathogens, whereas those with low cycle threshold values in SARS-CoV-2 NATs were amplified and sequenced to determine the SARS-CoV-2 variants. Finally, children positive for SARS-CoV-2 with clinical information in detail were enrolled in a follow-up study to identify potential factors significantly associated with long recovery. Results Among 9625 paediatric outpatients tested for nucleic acid of SARS-CoV-2, 733 (7.62%, 733/9625) were identified as SARS-CoV-2 NAT positive, with only three (0.82%, 3/366) co-infected with other pathogens among 366 randomly selected patients, and 71 (62.83%) determined as Omicron subvariant BF.7 and 42 (37.22%) as BA.5.2 among 113 successfully sequenced. Among the 681 patients with complete clinical information, fever was the most common symptom (96.8%). In a follow-up study of 592 patients, 46.96% became asymptomatic on the third day and 65.71% on the fifth day. Only 1.7% of infected children experienced febrile seizures. Combined with abnormal C-reactive protein, a higher percentage of antibiotics administration was observed. More co-living members and longer duration of first symptoms served as independent risk factors for long-term recovery, especially in children vaccinated for SARS-CoV-2. Conclusions BF.7 and BA.5.2 were the dominate Omicron subvariants and caused milder infections during the SARS-CoV-2 outbreak in Beijing. The number of co-living members and duration of first symptoms were independent risk factors for long-term recovery.

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Balancing Risks in the Time of COVID-19

Cited by 5 publications

References 12 publications

Supporting Breastfeeding in 2021 and Beyond—Lessons from the Pandemic

Supporting Breastfeeding in 2021 and Beyond—Lessons from the Pandemic

Respiratory Failure in an Extremely Premature Neonate with COVID-19

Clinical characteristics of abruptly increased paediatric patients with Omicron BF.7 or BA.5.2 in Beijing

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