COVID-19 in Neonates and Infants: Progression and Recovery

Abstract

Since 31 December 2019 and as of 7 April 2020, over 1.3 million (1 316 988) cases of COVID-19 have been reported worldwide, and more than 70 000 (74 066) deaths. Half of these cases (608 500) have been reported from the EU/EEA countries and the UK, and over 50 000 (51 059) of them have died. Overall, large increases in COVID-19 cases and deaths continue to be reported from the EU/EEA countries and the UK. In addition, in recent weeks, the European all-cause mortality monitoring system showed all-cause excess mortality above the expected rate in Belgium,

Synthesis and systematic review of reported neonatal SARS-CoV-2 infections

“…Only two neonatal infections were diagnosed by the presence of IgM in newborn blood 29,82 : these cases qualified as possible congenital and probable postpartum acquired infections, respectively, according to the classification system 16 ; all the other cases had at least one positive RT-PCR. Nine (5.1%) neonates required delivery room resuscitation 19,20,38,41,44,69,77,87 and 67 (38.3%) needed to be admitted to the NICU 17,18,20,27,31,33,35,36,38,41,44,45,[47][48][49][51][52][53][57][58][59]61,62,[64][65][66][69][70][71][72][73]77,[80][81][82][85][86][87]<...>…”

“…Clinical features of neonatal SARS-CoV-2 infections. Ninetyseven neonates presented with clinical features related to COVID-19: 18,20,[26][27][28]30,32,[34][35][36][38][39][40][41]44,45,[50][51][52]55,56,58,60,61,[65][66][67][70][71][72]77,78,80,81,[85][86][87][88]90 their distribution is shown in Table 3. Respiratory manifestations mainly consisted of signs of respiratory failure, such as tachypnoea, intercostal retractions, and rhinitis; neonatal ARDS was not diagnosed in any case.…”

“…Inflammatory markers (Creactive protein and procalcitonin) were increased in 15 (15.5%) out of 97 neonates 20,27,38,40,43,45,49,59,70,72,[80][81][82]88 . Lung imaging was abnormal in 62 (64%) out of 97 neonates and consisted of an interstitialalveolar pattern at lung ultrasound or chest X-ray and ground-glass opacities at CT-scan 17,19,21,23,27,29,32,36,38,44,45,51,53,55,58,59,[64][65][66][69][70][71]73,[77][78][79][80]82,85,88,90 . One neonate presenting with neurological manifestations also showed bilateral gliosis of the deep white periventricular and subcortical matter, together with signs of cerebral vasculitis, which was not totally remitted at the hospital discharge 77 .…”

Home Management of Children With COVID-19 in the Emilia-Romagna Region, Italy

“…The hospitalized children were significantly younger than those managed at home, and they might have been hospitalized out of fear of a potential negative evolution of COVID-19 in younger children than for real clinical reasons. On the other hand, studies have highlighted that among children with severe COVID-19, those with the highest risk of developing severe clinical manifestations are the youngest, particularly those younger than 5 years (8)(9)(10)(11). Limitations of these study include its retrospective design and the fact that it was conducted in a single Region of Italy.…”

Aktualisierte Empfehlungen zu SARS-CoV-2/COVID-19 und Schwangerschaft, Geburt und Wochenbett

“…In den bisher publizierten Fallserien zu Neugeborenen SARS-CoV-2-positiver Mütter kommen symptomatisch erkrankte Neugeborene und einzelne Todesfälle bei Frühgeborenen SARS-CoV-2-positiver Mütter vor. Es ist jedoch nicht sicher, dass die entsprechenden Symptome durch eine Infektion mit SARS-CoV-2 verursacht wurden [30][31][32].…”