Abstract
Coronavirus disease-19 (COVID-19) 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 low-middle-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 long-term follow-up. What is Known: • SARS-CoV-2 infection has a predilection for all age groups but with limited literature on clinical profile, outcomes, and long-term follow-up in neonates. What is New: • SARS-CoV-2 infection in neonates has a wide clinical spectrum and displays a significant overlap with common neonatal conditions. • Most neonates with COVID-19 improved with supportive care, though a subset required intensive care, emphasizing the need for cautious monitoring and management.
Keywords: Antibodies; COVID-19; Coronavirus; Low-middle income; Newborn; RT-PCR.
【저자키워드】 COVID-19, antibodies, coronavirus, RT-PCR, Newborn, Low-middle income, 【초록키워드】 Treatment, coronavirus disease, SARS-CoV-2, pandemic, intensive care, Clinical characteristics, knowledge, SARS-COV-2 infection, creatine, Infection, LDH, severe acute respiratory syndrome coronavirus-2, outcome, severe acute respiratory syndrome Coronavirus, RT-PCR, lactate dehydrogenase, invasive ventilation, observational study, outcomes, Severe acute respiratory syndrome, Nasopharyngeal swab, Neonate, Neonates, Coronavirus disease-19, IgM antibodies, management, Laboratory parameters, surfactant, morbidity and mortality, creatine kinase, incidence, Coronavirus-2, Lactate, retrospective, supportive care, manifestation, Neonatal, Long-term follow-up, natural history, reverse transcriptase, Chain Reaction, vulnerable population, Non-invasive, acute respiratory syndrome, Supportive treatment, neonatal period, CK-MB, overlap, acute respiratory syndrome coronavirus, IgM antibody, all age groups, acute respiratory syndrome coronavirus-2, positive, term, MOST, parameter, gastrointestinal system, implication, gastrointestinal systems, Surfactant instillation, Course, caused, evaluated, required, elevated, demonstrated, suggested, subset, conditions, all age group, with COVID-19, 【제목키워드】 India, outcome, Neonate, clinical feature, single-center,