SARS-CoV-2 Infection and Possible Neonatal Neurological Outcomes: A Literature Review

Moraes, Flávia Maciel de; Souza, Julia Werneck Paulino Soares de; Alves, Letícia Pires; Siqueira, Milena Ferreira Ribeiro de; Santos, Ana Paula Aguiar dos; Berardo, Mariana Monteiro de Carvalho; Granja, Marcelo Gomes; Castro‐Faria‐Neto, Hugo C.

doi:10.3390/v14051037

Cited by 4 publications

(3 citation statements)

References 96 publications

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“…Pregnant women with COVID-19 will inevitably come into close contact with their neonates because of the need to feed and care for their child. The 22 full-term neonates with COVID-19 in this study all lived in the same room as the mothers, who were diagnosed with the COVID-19, indicating that the SARS-CoV-2 Omicron strain is highly contagious and demonstrating that horizontal transmission is the most important mode of neonatal infection [4][5] . In this study, a premature infant was delivered by cesarean section under conditions of tertiary protection by medical staff and did not come in contact with the COVID-19-positive mother after birth.…”

Section: Discussionmentioning

confidence: 66%

Clinical analysis of 23 cases of neonatal Omicron (a variant of SARS-CoV-2) infection in Suzhou

Zhang,

Ma,

et al. 2023

Preprint

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Objective To analyze the clinical characteristics of neonatal cases of severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection in Suzhou since December 2022. Methods In this retrospective case series study, the clinical data of 23 neonates with SARS-CoV-2 infection at our hospital from December 10, 2022, to January 10, 2023, were collected, and the epidemiological history, clinical manifestations and outcomes, laboratory changes, etc., were analyzed. Results Among the 23 infants, there were 9 males and 14 females, 22 full-term infants, and 1 premature infant (35 weeks+ 1). The oldest was 27 days old, and the youngest was premature. Age at diagnosis was 14(9.0,19.0) days. The mothers were all prenatally diagnosed with coronavirus disease 2019 (COVID-19). All 22 full-term infants lived with their mothers in the same room. Among them, 8 were exclusively breastfed, 14 were mixed-fed, and 1 was a preterm infant who was not breastfed. Twenty-two neonates were infected by horizontal transmission, and 1 was infected by suspected vertical transmission from mother to child. The clinical classification included 1 asymptomatic infection, 20 mild infections, 2 moderate infections. The most common clinical manifestations were fever (21 neonates), and the fever duration was 1–6 days. Other clinical manifestations included respiratory symptoms(18 neonates), digestive tract symptoms(12 neonates) and abdominal distension (2 neonates). Neurological symptoms included mild drowsiness, irritability, and crying (3 neonates). The other symptoms included 4 cases of jaundice and 2 cases of rash. The white blood cell count was lower than 4.0*109/L in 1 neonate. The lymphocyte count was lower than 1.0*109/L in 1 neonate. Interleukin-6 was normal in 3 neonates, slightly elevated in 11 neonates, and greater than 200 pg/ml in 2 neonates. Procalcitonin was slightly elevated in 1 neonate. The creatine phosphokinase isoenzyme (CK-MB) was slightly elevated in 4 neonates. Two neonates had flocculent high-density shadows in chest X-ray. 21 patients were cured and discharged, while another 2 patients were discharged after improvement; the length of hospitalization was 3.8 (4.0,5.0)days. Twenty-one patients were followed up and no repeated clinical manifestations were reported. Conclusion SARS-CoV-2 infection in neonates in this area was mainly transmitted horizontally and mainly mild cases, with mild clinical symptoms and mildly increased inflammatory indicators. The short-term prognosis was good.

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Section: Discussionmentioning

confidence: 66%

Clinical analysis of 23 cases of neonatal Omicron (a variant of SARS-CoV-2) infection in Suzhou

Zhang,

Ma,

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…For this reason, patients discharged with their mothers should be checked for one or two weeks after discharge for symptoms [155] . Since there is concern about cardiorespiratory and neurological complications in the medium and long term and these neonates [165] , they should be followed up.…”

Section: The Placenta Fetus and Neonatementioning

confidence: 99%

Functional consequences of SARS-CoV-2 infection in pregnant women, fetoplacental unit, and neonate

Carvajal

Casanello

Farías

et al. 2023

Biochimica et Biophysica Acta (BBA) - Molecular Basis of Diseas

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“…Because there is exceptional collateral circulation in the brain vasculature in the neonatal period and early childhood, the pattern of parenchymal involvement in these subjects tends to be less severe in the cortical gray matter (unlike in adults). In response to vascular and/or hypoxic encephalic injury, the deep white matter is one of the first areas of the brain affected during this early period of life (22)(23)(24).…”

Section: Ultrasonographic Findings (Gray Scale)mentioning

confidence: 99%

Neuroimaging assessment of pediatric cerebral changes associated with SARS-CoV-2 infection during pregnancy

et al. 2023

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BackgroundSARS-CoV-2 infection and perinatal neurologic outcomes are still not fully understood. However, there is recent evidence of white matter disease and impaired neurodevelopment in newborns following maternal SARS-CoV-2 infection. These appear to occur as a consequence of both direct viral effects and a systemic inflammatory response, with glial cell/myelin involvement and regional hypoxia/microvascular dysfunction. We sought to characterize the consequences of maternal and fetal inflammatory states in the central nervous system of newborns following maternal SARS-CoV-2 infection.MethodsWe conducted a longitudinal prospective cohort study from June 2020 to December 2021, with follow-up of newborns born to mothers exposed or not exposed to SARS-CoV-2 infection during pregnancy. Brain analysis included data from cranial ultrasound scans (CUS) with grayscale, Doppler studies (color and spectral), and ultrasound-based brain elastography (shear-wave mode) in specific regions of interest (ROIs): deep white matter, superficial white matter, corpus callosum, basal ganglia, and cortical gray matter. Brain elastography was used to estimate brain parenchymal stiffness, which is an indirect quantifier of cerebral myelin tissue content.ResultsA total of 219 single-pregnancy children were enrolled, including 201 born to mothers exposed to SARS-CoV-2 infection and 18 from unexposed controls. A neuroimaging evaluation was performed at 6 months of adjusted chronological age and revealed 18 grayscale and 21 Doppler abnormalities. Predominant findings were hyperechogenicity of deep brain white matter and basal ganglia (caudate nuclei/thalamus) and a reduction in the resistance and pulsatility indices of intracranial arterial flow. The anterior brain circulation (middle cerebral and pericallosal arteries) displayed a wider range of flow variation than the posterior circulation (basilar artery). Shear-wave US elastography analysis showed a reduction in stiffness values in the SARS-CoV-2 exposed group in all analyzed regions of interest, especially in the deep white matter elasticity coefficients (3.98 ± 0.62) compared to the control group (7.76 ± 0.77); p-value < 0.001.ConclusionThis study further characterizes pediatric structural encephalic changes associated with SARS-CoV-2 infection during pregnancy. The maternal infection has been shown to be related to cerebral deep white matter predominant involvement, with regional hyperechogenicity and reduction of elasticity coefficients, suggesting zonal impairment of myelin content. Morphologic findings may be subtle, and functional studies such as Doppler and elastography may be valuable tools to more accurately identify infants at risk of neurologic damage.

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SARS-CoV-2 Infection and Possible Neonatal Neurological Outcomes: A Literature Review

Cited by 4 publications

References 96 publications

Clinical analysis of 23 cases of neonatal Omicron (a variant of SARS-CoV-2) infection in Suzhou

Clinical analysis of 23 cases of neonatal Omicron (a variant of SARS-CoV-2) infection in Suzhou

Functional consequences of SARS-CoV-2 infection in pregnant women, fetoplacental unit, and neonate

Neuroimaging assessment of pediatric cerebral changes associated with SARS-CoV-2 infection during pregnancy

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