Clinical characteristics of confirmed COVID-19 in newborns: a systematic review

Abstract

Objective: Aim of this systematic review is to investigate the available evidence describing neonatal outcomes in newborns who have SARS-CoV-2 infection in order to guide prevention of COVID-19 in newborns. Methods: This is the study protocol for a systematic review. MEDLINE, Web of Science, PubMed, Science Direct, CINAHL, Scopus, Cochrane, TUB _ ITAK databases, and key words of "Newborn" (neonatal OR clinical characteristics newborn OR infants less than 1 month OR infants less than 28 weeks OR Neonate) AND "clinical presentation" (epidemiology OR symptoms OR clinical course OR features) AND "COVID-19" (Coronavirus OR COVID-19 OR Sars-Cov2 OR coronavirus disease 2019 OR Novel Coronavirus OR 2019-nCoV) were searched for this systematic review. Randomized controlled trial, cross-sectional, case-control, and case reports, case reports examining neonatal outcomes in newborns who have SARS-CoV-2 infection were included. Studies were selected according to criteria around the population, intervention, comparator, outcome(s) of interest, and study design (PICOS framework). All citations and full-text articles were searched by independent five authors. The population that newborns with COVID-19 that confirmed within 28 d of birth are included. The interventions included in COVID-19 infection diagnosed via reverse transcription-polymerase chain reaction (RT-PCR) or serological. The primary outcomes were Neonatal clinical outcomes. The methodological quality of the studies was appraised using appropriate tools. Strength of the body of evidence was assessed according to the quality assessment tool for quantitative studies (QATQS). Results: The electronic search identified 1051 records that were examined, after evaluating 35 of them were included in the study. Seven studies were research articles and twenty-eight were case reports. Methodological quality was medium. Most of the clinical characteristics of newborns were respiratory difficulty and secondly fever. Some newborns gastrointestinal (GIS) symptoms in the form of diarrhea and feeding intolerance and abdominal distension were present in 50%. The fatality case did not exist in any newborn due to COVID-19. Death occurred in one case due to prematurity. Conclusıons: The most common symptoms in patients with COVID-19 infection in the neonatal period are respiratory tract symptoms and fever. It has been observed that the COVID-19 infection detected in the neonatal period is not fatal. However, data including more cases are needed.

Epidemiologic and clinical characteristics of neonates with late-onset COVID-19: 1-year data of Turkish Neonatal Society

“…This may be explained by the subjectivity of this symptom. Respiratory symptoms, i.e., cough, tachypnea, retractions, and rhinorrhea, were the main symptoms, as expected, similar to other adult and child series [17][18][19][20][21][24][25][26][27][28]. Among the respiratory symptoms, cough, retractions, and tachypnea on admission were independent predictors of more severe disease; however, this may be due to our use of the severity classification system of Dong et al [17].…”

“…However, neonates must be evaluated and treated differently from other children. There have been some neonatal case reports and series differing in severity [21]. In our cohort, we included neonates who required medical help, and were either symptomatic or had a contact history.…”

A single-center observational study on clinical features and outcomes of 21 SARS-CoV-2-infected neonates from India

“…A review by Sheth et al reported a 30% prematurity rate in infected neonates [4]. Karabay et al in their systematic review found no significant relationship between birth weight and frequency of infection [23]. A lower mean birth weight with one-third being small for gestational age was probably due to a study being conducted in a public hospital catering to the low-middle class population with poor health-seeking behavior.…”

Rooming-In Practice During the Pandemic: Results From a Retrospective Cohort Study

“…The first limitation of this study was that none of the neonates enrolled were tested for SARS-CoV-2 using nasopharyngeal swab after discharge. This information would have been epidemiologically important, as it has been reported that half of the neonates with SARS-CoV-2 infection may be asymptomatic (Karabay et al, 2020; Raschetti et al, 2020), so we cannot conclude that no newborn became positive for SARS-CoV-2 after discharge. The second limitation of this study was the failure to include late preterm and low birthweight infants, impairing the generalizability of our findings.…”