Could red cell distribution width be used for predicting cardiac injury in neonates with COVID‐19?

Abstract

Background Coronavirus disease 2019 (COVID‐19) can affect people of all age groups and it can occasionally cause life‐threatening clinical illnesses in immunologically immature populations, especially in newborns. High red cell distribution width (RDW) values were used as an early prognostic biomarker of some neonatal diseases. We aimed to determine the prognostic value of RDW in severe acute respiratory syndrome‐coronavirus‐2 (SARS‐CoV‐2) infected neonates. Methods Newborns with positive SARS‐CoV‐2 polymerase chain reaction (PCR) test from a nasopharyngeal swab sample, who had refractory fever (>38°C and lasting more than 24 h during hospitalization), were screened for multisystem inflammatory syndrome in newborns (MIS‐N), systemic inflammatory indexes calculated and cardiologic evaluations. Due to troponin levels (high: >45 ng/L and low: ≤45 ng/L) patients were grouped. Results Out of the 68 SARS‐CoV‐2 PCR‐positive newborns, 26 patients had refractory fever. Comparison of laboratory findings between the high and low‐troponin groups showed that RDW and neutrophil/lymphocyte ratio values were significantly higher in patients with high troponin levels ( p = 0.022 and p = 0.030, respectively). The cut‐off values with optimal sensitivity and specificity were determined as 1.00 for neutrophil/lymphocyte ratio ( p = 0.205) and 16.6 for RDW ( p = 0.014). None of the patients died. Conclusions Neonatal COVID‐19 generally has a benign prognosis, but can progress to severe disease and cases of MIS‐N are rare. RDW could be prognostic in the diagnosis and management of neonates with SARS‐CoV‐2 infection with high troponin levels.

COVID-19 among infants: key clinical features and remaining controversies

“…The variations inherent in such illnesses have become more apparent; therefore, several clinical definitions have emerged. Overall, it is suggested that very few SARS-CoV-2-infected children suffer from MIS-C [ 59 , 78 , 79 ]. Among all pediatric MIS-C in 2 of the latter studies, some 1.7%–2.6% were <1 year of age.…”

“…geogra phic regions and with now considerable cumulative numbers. 3,5,[9][10][11]13,[21][22][23][24]26,[30][31][32]34,41,45,46,48,[51][52][53][58][59][60][61][62] Table 1 details the more common disease features cited to date. Small case series, case reports, and reviews have mostly been consistent.…”