Clinical features of neonates born to mothers with coronavirus disease-2019: A systematic review of 105 neonates

Abstract

Background Despite the increasingly recognized impact of novel coronavirus disease (COVID-19), caused by severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2), on many aspects of health in adults and children, its effects on neonates born to infected mothers remain unclear. We conducted this study to investigate the outcomes of neonates born to mothers with COVID-19. Methods We searched the medical databases from inception to March 31, 2020 to perform a systematic review of outcomes in neonates born to mothers with COVID-19. Data were pooled using a random effects regression model. Primary and secondary outcomes were neonatal clinical outcomes and infectious status, respectively. Results Fourteen studies involving 105 neonates fulfilling the study criteria were identified. The rates of preterm neonates and those small for gestational age (SGA) were 25 (23.8%) and 10 (11.2%), respectively. Among 91 neonates who were tested, 8 (8.8%) were positive for nucleic acids or antibodies for SARS-CoV-2. Additionally, 28 (26.7%) of the neonates were symptomatic and two test-negative neonates died, including one stillbirth. Between test-positive and test-negative groups, the rates of SGA, preterm delivery, duration between maternal symptom onset and delivery, and perinatal complication were not significantly different; but the rate of symptomatic after birth reached significant difference (62.5% vs 20.5%, p = 0.008). Conclusions Most neonates born to infected mothers had favorable outcomes. Although direct evidences of intrauterine infection were scarce, the risk of intrauterine infection should be considered based on a positive test in 8.8% of the neonates. Symptomatic neonates born to infected mothers should receive tests for SARS-CoV-2 to initiate appropriate treatment and quarantine. Further studies are warranted to assess the outcomes of COVID-19 in neonates.

Maternal and Neonatal Characteristics and Outcomes of COVID-19 in Pregnancy: An Overview of Systematic Reviews

“…After the application of the eligibility criteria, 39 studies were finally included [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ], one (2.6%) of which was described as “rapid” [ 42 ] and two (5.1%) as “scoping” systematic reviews [ 30 , 50 ]. Thirteen (33%) of them also undertook a meta-analysis [ 14 , 16 , 18 , 19 , 24 , 25 , 27 , 36 , 38 , 40 , 48 ,…”

“…Thirteen (33%) of them also undertook a meta-analysis [ 14 , 16 , 18 , 19 , 24 , 25 , 27 , 36 , 38 , 40 , 48 , 49 , 52 ]. Twenty-nine (74%) reviews evaluated quality of individual studies [ 14 , 15 , 16 , 19 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 37 , 41 , 42 , 43 , 44 , 46 , 47 , 48 , 51 , 52 ], with one of them doing so, in a subjective manner, without utilizing any assessment tool [ 42 ]. Among the eligible systematic reviews’ last search dates, the most recent one took place on 8 July 2020.…”

“…Among the eligible systematic reviews’ last search dates, the most recent one took place on 8 July 2020. Nineteen studies (48.7%) contained only confirmed women for SARS-CoV-2 [ 14 , 15 , 16 , 18 , 19 , 20 , 23 , 24 , 27 , 28 , 36 , 37 , 38 , 43 , 45 , 46 , 48 , 49 , 52 ] (2 studies used the term “laboratory confirmed COVID-19” [ 14 , 19 ], 6 studies the term “confirmed COVID-19” [ 16 , 18 , 28 , 38 , 48 , 49 ], 10 studies the term “PCR-confirmed” [ 15 , 20 , 23 , 24 , 27 , 36 , 37 , 43 , 46 , 52 ] and one study the term “COVID-19 positive” [ 45 ]), fourteen (35.9%) included either PCR-confirmed or women whose diagnosis of COVID-19 was based on clinical and/or radiological findings, without further laboratory confirmation [ 17 , 21 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 40 , 44 ,…”

One-Seventh of Patients with COVID-19 Had Olfactory and Gustatory Abnormalities as Their Initial Symptoms: A Systematic Review and Meta-Analysis

“…This study was approved by the Institutional Review Board of the MacKay Memorial Hospital, Taipei, Taiwan (approval number, 20MMHIS140e) and was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines [9,10]. Comprehensive keywords were used, such as "COVID-19", "COVID-2019", "severe acute respiratory syndrome coronavirus 2", "2019-nCoV", "2019nCoV", "SARS-CoV-2", and "Wuhan" with Boolean operators and MeSH terms.…”

Taiwan Government-Guided Strategies Contributed to Combating and Controlling COVID-19 Pandemic

“…Government-guided strategies contributed to controlling the disease's spread and may be beneficial for reference by other countries' health policy makers and healthcare providers. Timely quarantine and identification of infectious sources are essential to reduce virus transmission (23,24). However, people may be afraid of quarantine and may even conceal their travel history.…”