Point-of-care lung ultrasound in three neonates with COVID-19

Abstract

Since March 2020, the world is involved in the COVID-19 pandemic, a disease caused by a novel virus called SARS-CoV-2. Some authors have described the ultrasonographic findings of COVID-19 pneumonia in adults and children, but data on neonates are lacking. Our objective was to describe the ultrasonographic lung pattern on newborns with SARS-CoV-2 infection during the COVID-19 pandemic. Newborns who tested positive for SARS-CoV-2 PCR in respiratory samples and were evaluated with point-of-care lung ultrasound (LU) from March to April 2020 were included. LU was performed bedside by a single investigator at the time of diagnosis and every 48 h during the first week following diagnosis. Six areas were studied. Three neonates were included. Infants' comorbidities included meconium aspiration syndrome, bronchopulmonary dysplasia, and Hirschsprung's disease. One required mechanical ventilation. No deaths occurred. LU showed B-lines, consolidation, and spared areas. No pneumothorax or pleural effusion was observed Conclusions: LU could be of value when managing COVID-19 neonates. We describe the findings of lung ultrasound monitoring during the first week following diagnosis in three neonates with SARS-CoV-2 infection.What is known:• Lung ultrasound (LU) is a useful tool in COVID-19 management in adults. To date, no report on LU and neonates with SARS-CoV-2 infection has been published. What is new:• This study adds evidence about LU findings in neonates with SARS-CoV-2 infection.

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

“…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.…”

“…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).…”

Clinical profile, viral load, management and outcome of neonates born to COVID 19 positive mothers: a tertiary care centre experience from India

“…The radiological evaluation (chest X-Ray) was normal for the neonate who needed CPAP as respiratory support. Comorbidities like meconium aspiration syndrome have been reported in previous reports too by Gregorio et al who described the use of lung ultrasound in the monitoring of respiratory morbidities in 3 neonates with COVID 19 infection [55].…”

Neonatal COVID-19 exposures and infections: a systematic review of modes of transmission, manifestations and management

“…Fifty-six studies were included in this review. Thirty one of the studies were conducted in China while the remaining studies were carried out in Iran (five) 1,14-17 , South Korea (two) 2, 18 , USA (seven) 3,[19][20][21][22][23][24] , Italy (four) [25][26][27][28] , Spain (three) [29][30][31] , Peru (one) 4 , France (one) 32 , Australia (one) 33 , Belgium (one) 34 (Table 1). All the studies were published between January and August 2020 (Table 1 Table 1).…”