Is COVID in Neonates Really Mild?

Khamkar, Anilkumar M; A, Mahindre; Pote, P D; Suryawanshi, Pradeep; Jose, Georgeena Elsa

doi:10.1007/s12098-021-03865-8

Cited by 2 publications

(2 citation statements)

References 3 publications

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“…While symptomatic neonates may require admission to the intensive care unit (ICU) (7), most present with mild COVID-19 symptoms, maintain spontaneous respiration, and have good overall prognosis (8,9). Vertical transmission appears to be rare (9,10) but the rate of communityacquired COVID-19 in neonates is rising due to highly transmissible variants (11,12), with the geographic areas most affected by COVID-19 changing over time (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Neonatal COVID-19 in the United States

et al. 2022

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OBJECTIVE Data on COVID-19 infections in neonates are limited. We aimed to identify and describe the incidence, presentation, and clinical outcomes of neonatal COVID-19. METHODS Over 1 million neonatal encounters at 109 US health systems, from March 2020 to February 2021, were extracted from the Cerner® Real World Database. COVID-19 diagnosis was assessed using SARS-CoV-2 laboratory tests and diagnosis codes. Neonates were defined as patients aged ≤28 days on hospital admission. Incidence of COVID-19 per 100,000 encounters was estimated. RESULTS COVID-19 was diagnosed in 918 (0.1%) neonates (or 91.1/100,000 encounters [95% CI 85.3 – 97.2]). Of these, 71 (7.7%) had severe infection (7/100,000 [95% CI 5.5 – 8.9]). Median time to diagnosis was 14.5 days from birth (interquartile ratio 3.1 – 24.2). Common signs of infection were tachypnea and fever. Those with severe infection were more likely to receive respiratory support (50.7% vs 5.2%, p <0.001). Severely ill neonates received analgesia (38%), antibiotics (33.8%), anticoagulants (32.4%), corticosteroids (26.8%), remdesivir (2.8%) and COVID-19 convalescent plasma (1.4%). A total of 93.6% neonates were discharged home, 1.1% were transferred to another hospital, and discharge disposition was unknown for 5.2%. One neonate (0.1%) with presentation suggestive of Multisystem Inflammatory Syndrome in Children died after 11 days of hospitalization. CONCLUSION Most neonates infected with SARS-CoV-2 were asymptomatic or developed mild illness without need for respiratory support. Some neonates had severe illness requiring treatment for COVID-19 with remdesivir and CCP. Thus, SARS-CoV-2 infection in neonates, though rare, may result in severe disease.

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Section: Introductionmentioning

confidence: 99%

Epidemiology of Neonatal COVID-19 in the United States

et al. 2022

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“…Similarly, hospitalization should be advised for unwell patients at the time of admission due to reported anecdotal cases of myocarditis and encephalitis related to SARS-CoV-2, even in the neonatal and childhood periods [ 2 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Course, Laboratory Findings, and Prognosis of SARS-CoV-2 Infection in Infants up to 90 Days of Age: A Single-Center Experience and a Proposal for a Management Pathway

Bellini,

Brisca,

Orfanos

et al. 2024

Healthcare

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Aim: To provide a comprehensive description of the clinical features, biochemical characteristics, and outcomes of infants up to 90 days old with COVID-19. Moreover, to assess the severity of the disease and propose an effective management pathway. Methods: Retrospective single-center study spanning three years. Patient data includes age, sex, symptoms, comorbidities, blood and urine test results, cultures, admission, length of stay, therapies, intensive care unit admission, and mortality. Results: A total of 274 patients were enrolled in the study, comprising 55% males. Among them, 60 patients (22%) were under the age of 29 days, while 214 (78%) fell within the 29 to 90 days age range. The overall incidence of SARS-CoV-2 infections was 0.28 per 10,000 Pediatric Emergency Department admissions. Blood inflammatory markers showed no significant abnormalities, and there were no recorded instances of positive blood cultures. Less than 1% of infants showed urinary tract infections with positive urine cultures, and 1.5% of patients had a concurrent RSV infection. Hospitalization rates were 83% for neonates and 67% for infants, with a median length of stay (LOS) of 48 h for both age groups. None of the patients required admission to the Pediatric or Neonatal Intensive Care Unit, and only one required High Flow Nasal Cannula (HFNC). No secondary serious bacterial infections were observed, and all hospitalized patients were discharged without short-term sequelae. No deaths were reported. Discussion and Conclusions: Infants with COVID-19 generally exhibit milder or asymptomatic forms of the disease, making home management a viable option in most cases. Blood tests, indicative of a mild inflammatory response, are recommended primarily for children showing symptoms of illness. Hospitalization precautions for infants without apparent illness or comorbidities are deemed unnecessary. Given the evolving nature of experiences with COVID-19 in infants, maintaining a high level of clinical suspicion remains imperative.

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Is COVID in Neonates Really Mild?

Cited by 2 publications

References 3 publications

Epidemiology of Neonatal COVID-19 in the United States

Epidemiology of Neonatal COVID-19 in the United States

Clinical Course, Laboratory Findings, and Prognosis of SARS-CoV-2 Infection in Infants up to 90 Days of Age: A Single-Center Experience and a Proposal for a Management Pathway

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