Short-Term Outcomes in Neonates and Preterm Infants with SARS-CoV-2 Infection Acquired Postpartum

Abstract

Objective There are limited data regarding the hospital and postdischarge course of novel coronavirus disease 2019 (COVID-19) in newborns. This study aimed to present the data of such cases in newborns. Methods We retrospectively evaluated the predischarge and postdischarge records of newborns followed-up in the neonatal intensive care unit between June 2, 2020, and April 30, 2021 and who had positive polymerase chain reaction (PCR) test for COVID-19. Results Eleven newborns had positive PCR tests for COVID-19 during the study period. The prenatal COVID-19 PCR test of the mothers of the newborns was negative. The cases with a postnatal age of 10 to 60 days according to chronological age were hospitalized due to positive COVID-19 PCR test. Either or both the parents of these cases were severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) PCR positive on nasopharyngeal swab obtained simultaneously. All breast milk samples were negative for COVID-19 virus. The mean D-dimer value of the cases was 3,430 µg FEU/L at the time of hospitalization and 307 µg FEU/L after discharge. None of the cases were given any specific antiviral treatment. The cases were discharged with full recovery. No rehospitalizations or deaths occurred during the 3-month follow-up after discharge. Conclusion In most COVID-19 newborns, the disease was transmitted by infected parents, and the course of the infection was either asymptomatic or associated with only mild symptoms. No complications or deaths were observed during the 3-month follow-up after discharge.

Thromboembolic complications in newborns – diagnostic value of D-dimers concentration and proposed outline of enoxaparin use

“…Thrombin (IIa factor) then cleaves fibrinogen to fibrin and fibrin network is formed. In the next stage, proteolytic degradation of fibrin by plasmin takes place and the release of D-dimers, which are products of fibrin degradation [17, modified] of D-dimers, and to physiological mechanisms related to the closing of the venous duct (DV) and arterial duct (DA) in the newborn [43,44].…”

“…Plasma D-dimers concentration of 500 ng/ml -4,000 ng/ml in the absence of any TECs risk factors and the absence of any clinical symptoms suggesting thrombosis, indicates no need for pharmacotherapy and pharmacoprophylaxis, and does not constitute an indication for extending the diagnosis with additional laboratory tests and imaging diagnostics [39,54]. Plasma D-dimers concentration of 500 ng/ml -4,000 ng/ml in the absence of any TECs risk factor, but with any clinical symptom suggesting thrombosis, is an indication to extend the diagnosis by additional laboratory and imaging diagnostics [39,43,45,54]. Plasma D-dimers concentration of 500 ng/ml -4,000 ng/ml in the absence of any TECs risk factor, but in the presence of any clinical symptom suggesting thrombosis and in the absence of evidence of thrombosis in imaging diagnostics, indicates no need for pharmacotherapy and pharmacoprophylaxis and requires seeking another cause of symptoms [39,43,45,55].…”

“…Plasma D-dimers concentration of 500 ng/ml -4,000 ng/ml in the absence of any TECs risk factor, but with any clinical symptom suggesting thrombosis, is an indication to extend the diagnosis by additional laboratory and imaging diagnostics [39,43,45,54]. Plasma D-dimers concentration of 500 ng/ml -4,000 ng/ml in the absence of any TECs risk factor, but in the presence of any clinical symptom suggesting thrombosis and in the absence of evidence of thrombosis in imaging diagnostics, indicates no need for pharmacotherapy and pharmacoprophylaxis and requires seeking another cause of symptoms [39,43,45,55]. Plasma D-dimers concentration of 500 ng/ml -4,000 ng/ml in the absence of any risk factor for TECs, but with any clinical symptom suggesting thrombosis and the presence of signs of thrombosis in imaging diagnostics, indicates the need for the EX treatment dose [55].…”

“…Plasma D-dimers concentration of 500 ng/ml -4,000 ng/ml in the presence of any TECs risk factor requires extended imaging diagnostics in the newborn for TECs, regardless of the presence or absence of clinical symptoms suggesting thrombosis [39,43,45,55]. Plasma D-dimers concentration of 500 ng/ml -4,000 ng/ml in the presence of any TECs risk factor and no evidence of thrombosis in imaging diagnostics, indicates the need for a prophylactic dose of EX, regardless of the presence or absence of clinical symptoms [55].…”

“…Management of plasma D-dimers concentration >4,000 ng/ml. Plasma D-dimers concentration of >4,000 ng/ml is an indication for the inclusion of EX in therapeutic doses, regardless of the presence or absence of clinical symptoms suggesting thrombosis, and requires a detailed analysis of TECs risk factors and the extension of diagnostics to additional laboratory and imaging diagnostics [39,43,45,54,55,58]. The proposed treatment with plasma D-dimers concentration >,000 ng/ml is shown in Figure 2b.…”