COVID-19 in a 26-week preterm neonate

Piersigilli, Fiammetta; Carkeek, Katherine; Hocq, Catheline; Grambezen, Bénédicte Van; Hubinont, Corinne; Chatzis, Olga; Linden, Dimitri Van der; Danhaive, Olivier

doi:10.1016/s2352-4642(20)30140-1

Cited by 102 publications

(143 citation statements)

References 8 publications

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“…The mother had not previously been infected and was not infected by this neonate during the period of viral shedding despite the high viral load. As described in current literature, symptoms of COVID-19 in newborns were mild, or even none with complete recovery; which is consistent in our case report [ 7 , 10 , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] ]. In most cases, the mother was infected and probably transmitted horizontally to the neonate.…”

Section: Discussionsupporting

confidence: 92%

“…Eligible studies (including case reports, case series, cohort studies and retrospective studies) published in English-language journals that have described neonates diagnosed with COVID-19 were included for analysis. We summarized the studies involving neonates in Table 2A , Table 2B [ 10 , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] ]. Most of these neonates had an infected mother and were asymptomatic (n = 7) or became symptomatic after 16 hours until 17 days after birth (n = 20).…”

Section: Case Presentationmentioning

confidence: 99%

“…Furthermore, in children aged between 2 months and 15 years, SARS-CoV-2 RNA could still be detected in their stool in up to 70 days [ 4 , 8 , 9 ]. Data about duration of viral shedding in neonates is scarce [ 10 , 24 , 27 , 33 ].…”

Section: Introductionmentioning

confidence: 99%

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Case report of a neonate with high viral SARSCoV-2 loads and long-term virus shedding

Slaats¹,

Versteylen²,

Gast³

et al. 2020

Journal of Infection and Public Health

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Background SARS-CoV-2 has spread globally. Currently, literature of SARS-CoV-2 in neonates is scarce. We present a case of a neonate with a high viral load and prolonged virus shedding. Methods Epidemiology, clinical characteristics, treatment, laboratory data and follow-up information and the treatment of a neonate with COVID-19 were recorded. Results A 7-day-old boy was admitted to the hospital with fever, lethargy and apnoea. He was found SARS-CoV-2 RNA positive with an exceptionally high viral load in nasopharyngeal swab and stool. The father and two maternity nurses at home had detectable SARS-CoV-2 RNA as well. Sequencing showed all strains belonged to the same cluster. The father was asymptomatic and the maternity nurses developed symptoms after visiting. In the mother, no SARS-CoV-2 RNA could be found. Six days after admission, the neonate was discharged after clinical improvement with oral antibiotics because of a possible pyelonephritis. Monitoring the course of this infection showed that SARS-CoV-2 RNA was detectable in the nasopharynx until day 19 and in stool until day 42 after symptom onset. Conclusions This case shows that neonates can have a high viral load of SARS-CoV-2 and can shed the virus for over one month in stool. Despite the high viral load in the neonate, the mother and a sibling did not get infected.

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Section: Discussionsupporting

confidence: 92%

Section: Case Presentationmentioning

confidence: 99%

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Case report of a neonate with high viral SARSCoV-2 loads and long-term virus shedding

Slaats¹,

Versteylen²,

Gast³

et al. 2020

Journal of Infection and Public Health

View full text Add to dashboard Cite

show abstract

“…There is very limited data on the clinical course of preterm infants of less than 32 weeks of gestation (very preterm) born to mothers with SARS-CoV-2 infection, thereby presenting a significant challenge to the management of these infants. 4 5 We report here two very preterm infants born to mothers with COVID-19 with an atypical respiratory course complicated by air leak syndrome.…”

mentioning

confidence: 93%

Air Leak Syndrome in Two Very Preterm Infants Born to Mothers with Coronavirus Disease 2019: An Association or a Coincidence?

Reddy

Engelhardt

Jain

2020

AJP Rep

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The novel coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mostly affects adults with limited information on possible vertical transmission from pregnant mothers. We present here two very preterm infants born to mothers with COVID-19, whose respiratory course was significant for initial mild respiratory distress syndrome who developed acute onset severe air leak syndrome at approximately 24 to 36 hours of age requiring thoracentesis. Their respiratory status improved gradually with resolution of air leak and respiratory failure by 2 weeks of age. Both infants tested negative for SARS-CoV-2 by reverse transcriptase–polymerase chain reaction of multiple respiratory specimens collected beyond 24 hours after birth. As the incidence of severe air leak syndrome is relatively low in preterm infants without risk factors, this presentation in two very preterm infants born to mothers with COVID-19 is intriguing and needs to be further evaluated in larger cohorts. If confirmed, this data could potentially be the first step toward generating hypotheses for mechanisms of lung injury, intrauterine transmission, or how to detect COVID-19 in preterm infants. In addition, these data will be critical for developing evidence-based guidelines for perinatal management of these infants as we continue to battle against the COVID-19 pandemic for the foreseeable future.

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“…The clinical disease, was declared a global pandemic by WHO in March 2020 [2]. Data on neonatal infection with SARS-CoV-2 are limited [3][4][5]. The need for respiratory support in infants with Covid-19 is uncertain.…”

Section: Introductionmentioning

confidence: 99%

Electrostatic filters to reduce COVID-19 spread in bubble CPAP: an in vitro study of safety and efficacy

Davis

Pillow²,

Cooper

et al. 2020

Preprint

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Background: Bubble CPAP may be used in infants with suspected or confirmed COVID-19. Electrostatic filters may reduce cross-infection. This study aims to determine if including a filter in the bubble CPAP circuit impacts stability of pressure delivery. Methods: A new electrostatic filter was placed before (pre) or after (post) the bubble CPAP generator, or with no filter (control) in an in vitro study. Pressure was recorded at the nasal interface for 18 h (6 L/min; 7 cmH2O) on three occasions for each configuration. Filter failure was defined as pressure >9 cmH20 for 60 continuous minutes. The filter was weighed before and after each experiment. Results: Mean (SD) time to reach the fail-point was 257 (116) min and 525 (566) min for filter placement pre- and post-CPAP generator, respectively. Mean pressure was higher throughout in the pre-generator position compared to control. The filter weight was heavier at study end in the pre- compared to the post-generator position. Conclusions: Placement of the filter at the pre-generator position in a bubble CPAP circuit should be avoided due to unstable mean pressure. Filters are likely to become saturated with water over time. The post-generator position may accommodate a filter, but regular pressure monitoring and early replacement are required.

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COVID-19 in a 26-week preterm neonate

Cited by 102 publications

References 8 publications

Case report of a neonate with high viral SARSCoV-2 loads and long-term virus shedding

Case report of a neonate with high viral SARSCoV-2 loads and long-term virus shedding

Air Leak Syndrome in Two Very Preterm Infants Born to Mothers with Coronavirus Disease 2019: An Association or a Coincidence?

Electrostatic filters to reduce COVID-19 spread in bubble CPAP: an in vitro study of safety and efficacy

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