The clinical course of SARS-CoV-2 positive neonates

Bernardo, Giuseppe De; Giordano, Maurizio; Zollo, Giada; Chiatto, F.; Sordino, Desirée; Santis, Rita De; Perrone, Serafina

doi:10.1038/s41372-020-0715-0

Cited by 52 publications

(57 citation statements)

References 44 publications

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“…Based on current evidence, the clinical course and prognosis of neonates with COVID-19 is good. Compared to adults, neonates are less likely to develop severe complications [1,4,25]. The duration of hospitalization ranges from 6 to 25 days [1,5].…”

Section: Discussionmentioning

confidence: 99%

“…When symptomatic, they may exhibit a wide-spectrum of predominantly mild non-specific respiratory (cough or difficulty in breathing, nasal congestion, sneezing), neurological (fever), and gastrointestinal (poor oral intake, vomiting, diarrhoea, abdominal distension, gastric haemorrhage) manifestations. Clinical signs may include lethargy, hypotension, tachypnea, apnoea, grunting, tachycardia, and cyanosis, intercostal retractions, temperature instability (fever, normothermia, or hypothermia), feeding intolerance, and mottling of the skin [1,4,8,25,26]. It is known that SARS-CoV-2 attaches to angiotensin converting enzyme-2 (ACE2) receptors to enter cells.…”

Section: Making the Diagnosis Of Sars-cov-2 In Neonates Clinical Charmentioning

confidence: 99%

“…RT-PCR may be performed on additional samples such as endotracheal aspirate, gastric aspirate, stool, plasma, urine, and saliva [1,5,25,26]. For a neonate whose mother is suspected or confirmed to have COVID-19, the first RT-PCR for SARS-CoV-2 nucleic acid should be done within 24 h of birth, and repeat testing at 48 h of age if the initial test is negative [23,29].…”

Section: Laboratory Evaluationmentioning

confidence: 99%

“…Chest X-ray and computerized tomography (CT) may show no abnormalities, or reveal features consistent with pneumonia such as bilateral linear opacities, ground glass opacities, increased lung markings, and consolidation [1,25,26]. In order to minimize radiation exposure, imaging should be performed when clinically necessary.…”

Section: Radiological Evaluationmentioning

confidence: 99%

“…Preliminary Chinese expert consensus guidelines proposed that high-dose pulmonary surfactant, inhaled nitric oxide, and high-frequency oscillatory ventilation may be effective for neonates with acute respiratory distress syndrome manifested by complete opacification of lungs [8]. Interestingly, the majority of neonates do not require invasive ventilation [1,25]. Intravenous glucocorticoids or immunoglobulin may be tried in some difficult cases.…”

Section: Managementmentioning

confidence: 99%

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2020

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Section: Discussionmentioning

confidence: 99%

Section: Making the Diagnosis Of Sars-cov-2 In Neonates Clinical Charmentioning

confidence: 99%

Section: Laboratory Evaluationmentioning

confidence: 99%

Section: Radiological Evaluationmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

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2020

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A single-center observational study on clinical features and outcomes of 21 SARS-CoV-2-infected neonates from India

et al. 2021

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caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is an ongoing pandemic with significant morbidity and mortality. Neonates represent a vulnerable population, in which we have limited knowledge of its natural history, optimal management, and outcomes. In this retrospective observational study from a lowmiddle-income setting, clinical characteristics and outcomes of neonatal SARS-CoV-2 infection were evaluated. We report an incidence of 10.6% of SARS-CoV-2 infection (21 neonates), among a group of 198 neonates with suspected infection. Most of the SARS-CoV-2-infected neonates were term (80.9%) and none required any resuscitation. The infection was detected by a positive nasopharyngeal swab reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2. Neonatal COVID-19 manifestations developed in one-third (33.3%) of the infected neonates. Most of them demonstrated the involvement of respiratory (33.3%) and gastrointestinal systems (4.8%). Laboratory parameters suggested multi-systemic involvement, with elevated creatine kinase (CK) (76.2%), creatine kinase-myocardial band (CK-MB) (76.2%), and lactate dehydrogenase (LDH) (71.4%) levels. Supportive treatment was given to infected neonates with intensive care required in six neonates (28.6%). This included four preterm and two term neonates, of which two received non-invasive and one received invasive ventilation with intra-tracheal surfactant instillation. IgM antibodies against COVID-19 were detected in one neonate. All neonates with COVID-19 improved and were successfully discharged.Conclusion: SARS-CoV-2 in neonates has a wide clinical spectrum. Further studies are needed which are adequately powered to completely understand the course of this infection in neonates, its implications not only in the neonatal period but also on longterm follow-up.

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Clinical characteristics of COVID-19 in neonates and young infants

et al. 2021

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We report the clinical characteristics and management of fourteen neonates and very young infants with COVID-19. Although all presented with mild symptoms and did not require specific treatment, most of them had abnormal laboratory and radiological findings. Ten infants presented with neutropenia and/or monocytosis but none with lymphopenia. Transient hypertriglyceridemia and/or prolonged viral shedding were detected in 9 patients.Conclusion: Based to our experience, COVID-19 is mild in very young infants and might have distinct laboratory findings. Keywords COVID-19 . Infants . SARS-CoV-2 . Pandemic Abbreviations BPD Bronchopulmonary dysplasia RT-PCR Real-time reverse transcriptase polymerase chain reaction SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Communicated by Nicole Ritz

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The clinical course of SARS-CoV-2 positive neonates

Cited by 52 publications

References 44 publications

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A single-center observational study on clinical features and outcomes of 21 SARS-CoV-2-infected neonates from India

Clinical characteristics of COVID-19 in neonates and young infants

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