Objective: We aimed to compare the clinical features, laboratory findings and primary outcomes of the neonates with RSV and neonates with SARS-CoV-2 infections. Materials and methods: This nested case-control study included the neonates who were administered in the neonatal intensive care unit (NICU) of the University of Health Sciences, Dr Behc¸et Uz Children's Hospital during the period of 01 March-30 April 2020. Respiratory PCR samples and COVID-19 samples were taken simultaneously. Only RSV positive and COVID-19 positive infants were compared. Demographic, epidemiological and clinical data were obtained from hospital electronic information system medical records. The chest radiographs at the admission were evaluated by using standard definitions for normal chest Xray, atelectasis, bronchopenumonia, peribronchial thickening and hyperinflation in various lung volumes. Results: A total of 30 infants were enrolled in the study and RSV was identified in 20/30 infants (66%). No significant differences were observed between the two groups in terms of general characteristics. Comparing to the infants with Covid-19 infections, infants with RSV infections had significantly higher rates of having oxygen support (p ¼ .03). Total NICU duration time was 6.7 ± 1.6 days in COVID positive group and 11.1 ± 5.1 days in the RSV group (p ¼ .01). Infants with COVID-19 had more normal chest X-rays. Infants with RSV-positive had a significantly higher proportion of atelectasis than those with COVID-19 infants (p ¼ .04). Discussion: This is the first study that compares RSV infection and COVID-19 infection. RSV infection can be more serious in the neonatal period. In cases with suspected COVID-19 infection, it should be kept in mind if atelectasis is seen on chest radiography. Respiratory failure may be more serious in RSV positive infants and RSV infection may be more dangerous for the neonatal period.
Objective In this study, we aimed to compare the clinical, laboratory, and radiological findings of noncoronavirus disease 2019 (COVID-19) viral agents in newborn infants hospitalized for lower respiratory tract infection during the COVID-19 pandemic. Methods This prospective cross-sectional study conducted between 11 March 2020 and 31 July 2021 included neonates with lower respiratory tract infections admitted to the neonatal intensive care unit of the Dr. Behcet Uz Children's Hospital. Nasopharyngeal swab samples were taken from all hospitalized patients for multiplex respiratory polymerase chain reaction (PCR) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR. The detection of respiratory viral pathogens was performed by multiplex real-time PCR assay (Bosphore Respiratory Pathogens Panel Kit V4, Anatolia Geneworks, Turkey). Infants with SARS-CoV-2 PCR positivity were excluded from the study. Patients' data were obtained from the electronic medical registry system. The non-COVID-19 viruses of the cases were analyzed according to seasonal variation (in/off-season). The pulmonary findings of the cases were classified as normal, infiltration, air bronchogram, and reticulogranular appearance at the time of admission. Results A total of 80 infants were included during the study period. A multiplex PCR test was performed to identify viral agents affecting the lower respiratory tract of infants; it was determined that 31% (25 out of 80) were respiratory syncytial virus (RSV), 41% (33 out of 80) were rhinovirus (Rhino), and the remaining portion (28%, 22 out of 80) were other viral agents (enterovirus, bocavirus, adenovirus, influenza, and parainfluenza). Compared with Rhino and other viral agents, RSV was detected most frequently in seasonal hospitalizations (p < 0.05). When chest radiography and laboratory findings were evaluated, the rate of “infiltration” /“lymphopenia” was significantly associated with infants with RSV lower respiratory tract infections (p < 0.05). Conclusion During the pandemic period, RSV affected the prognosis in intensive care unit admissions due to lower respiratory tract infection in newborns.
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