COVID-19: neonatal–perinatal perspectives

Abstract

The coronavirus disease 2019 (COVID-19) pandemic, resulting from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused severe and widespread illness in adults, including pregnant women, while rarely infecting neonates. An incomplete understanding of disease pathogenesis and viral spread has resulted in evolving guidelines to reduce transmission from infected mothers to neonates. Fortunately, the risk of neonatal infection via perinatal/postnatal transmission is low when recommended precautions are followed. However, the psychosocial implications of these practices and racial/ethnic disparities highlighted by this pandemic must also be addressed when caring for mothers and their newborns. This review provides a comprehensive overview of neonatal–perinatal perspectives of COVID-19, ranging from the basic science of infection and recommendations for care of pregnant women and neonates to important psychosocial, ethical, and racial/ethnic topics emerging as a result of both the pandemic and the response of the healthcare community to the care of infected individuals.

Use of VA ECMO and percutaneous palliation of ductal dependent coarctation in a neonate with trisomy 21 and COVID-19 pneumonia

“…The possible routes of transmissions of SARS-CoV-2 in the neonate include in utero, perinatal, and postnatal transmission and the data about this is still evolving [1]. In one d "Ground glass" infiltrates in CT chest.…”

“…g Chest X-ray post ECMO decannulation with resolution of infiltrates and vascular prostheses in situ. ECHO, echocardiogram; CT, computed tomography; PDA, patent ductus arteriosus; VA ECMO, venoarterial extracorporeal membrane oxygenation; ECMO, extracorporeal membrane oxygenation multinational study, the perinatal transmission was estimated to be around 3% and there is a suggestion that neonates with comorbidities and prematurity are more susceptible [1,2]. Also, COVID-19 disease may run a severe course in trisomy 21 [3].…”

“…Most neonatal infections are asymptomatic. However, severe illnesses such as acute respiratory distress syndrome (ARDS) and multi-organ dysfunction from viremia have been reported [1,2]. The treatment in the symptomatic neonate is supportive with unknown efficacy of drugs like remdesivir in the neonate.…”

“…The coronavirus disease 2019 (COVID-19) is an ongoing pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While the disease has been widespread and severe in adults, neonates are rarely infected [1]. We present a case of a neonate with severe COVID-19 pneumonia and congenital heart disease that was supported with venoarterial extracorporeal membrane oxygenation (VA ECMO) and the cardiac defect was palliated by a catheter intervention.…”

Nosocomial SARS-CoV-2 transmission in a neonatal unit in Botswana: chronic overcrowding meets a novel pathogen

“…1 However, neonates with COVID-19, especially those born prematurely with low birth weight (BW) and low energy stores, may be at higher risk of severe illness than older children, perhaps due to an immature immune response. 2 Symptoms of neonatal COVID-19 may be impossible to distinguish from sepsis, and may include fever, respiratory distress and poor feeding. 3 There are no specific therapies currently recommended for COVID-19 disease in neonates; treatment is supportive.…”