Supplemental Digital Content is available in the text. Background: The impact of SARS-CoV-2 on neonates remains largely unknown in low- and middle-income countries (LMICs). We provide an epidemiologic and clinical report of SARS-CoV-2 infections in neonates hospitalized in Bangladesh. Methods: Outborn neonates admitted to Dhaka Shishu Hospital, a tertiary-care referral hospital, between 29 March and 1 July were screened for SARS-CoV-2. We reviewed clinical data, including chest radiograph and laboratory reports, and conducted SARS-CoV-2 genome sequencing. Patients were followed-up for 27–75 days. A subset of caregivers was also tested. Results: Of 83 neonates tested, 26 were positive (median age 8 days). Most neonates were admitted with diagnosis unrelated to SARS-CoV-2: 11 presented with serious non-communicable diseases, 7 with early-onset sepsis, 5 with late-onset sepsis and 2 with pneumonia. In 3 of 5 chest radiograph, infiltrates and ground-glass or patchy opacities were noted. Two neonates developed metabolic acidosis, one developed disseminated intravascular coagulation. Most SARS-CoV-2 positive neonates were referred to government-designated COVID-19 hospitals, leading to gaps in treatment. Twenty-three neonates could be followed-up: 12 were healthy, 8 died and 3 were still seeking medical care. Of 9 caregivers tested, 8 were positive. Conclusions: SARS-CoV-2 may have serious adverse effects on children born in LMICs. The virus likely contributed directly to two deaths, but the remaining 6 neonates who died had serious comorbidities. Positive SARS-CoV-2 test results led to gaps in immediate clinical care for other morbidities, which likely contributed to adverse outcomes. This case series emphasizes the need to understand COVID-19 in neonates in LMICs and its indirect impacts.
【저자키워드】 COVID-19, SARS-CoV-2, Bangladesh, Neonates, low- and middle-income country, 【초록키워드】 Treatment, Hospitalized, Pneumonia, SARS-COV-2 infection, children, hospital, Comorbidities, Diagnosis, Sepsis, virus, adverse outcomes, hospitals, Laboratory, Neonate, Chest, Digital, clinical care, Care, non-communicable diseases, Disseminated intravascular coagulation, SARS-CoV-2 genome sequencing, deaths, adverse effect, Clinical data, median age, morbidities, early-onset, content, positive, SARS-CoV-2 test, MOST, country, impacts, tested, died, healthy, conducted, screened, case sery, contributed, subset, COVID-19 in neonate, patchy, seeking, 【제목키워드】 Neonate, Impact, Direct, Sery,