COVID-19 and Neonatal Respiratory Care: Current Evidence and Practical Approach

Shalish, Wissam; Lakshminrusimha, Satyanarayana; Manzoni, Paolo; Keszler, Martin; Sant’Anna, Guilherme M.

doi:10.1055/s-0040-1710522

Cited by 77 publications

(90 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Like in other age groups, major transmission routes in neonates are respiratory droplets, contact transmission and aerosol transmission (20). Data in this population are scarce, from small series included in larger studies on pediatric cases, in which, unlike adults, clinical manifestations have been reported to be mild (21). Interestingly, the proportion of severe and critical cases reported in children is inversely correlated with their age, and infections in infants <1 year old have been more severe (22).…”

Section: Introductionmentioning

confidence: 95%

Neonatal Infection Due to SARS-CoV-2: An Epidemiological Study in Spain

et al. 2020

View full text Add to dashboard Cite

Objective: Coronavirus disease 2019 (COVID-19) cases caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to increase worldwide. Although some data from pediatric series are available, more evidence is required, especially in neonates, a group with specific characteristics that deserve special attention. This study aimed to describe general and clinical characteristics, management, and treatment of postnatal-acquired (community and nosocomial/hospital-acquired) COVID-19 neonatal cases in Spain. Methods: This was a national prospective epidemiological study that included cases from a National Registry supported by the Spanish Society of Neonatology. Neonates with postnatal SARS-CoV-2 infection were included in this study. General data and infection-related information (mode and source of transmission, age at diagnosis, clinical Fernández Colomer et al. Neonatal Infection Due to SARS-CoV-2 manifestations, need for hospitalization, admission unit, treatment administered, and complementary studies performed, hospital stay associated with the infection) were collected. Results: A total of 40 cases, 26 community-acquired and 14 nosocomial were registered. Ten were preterm newborns (2 community-acquired and 8 nosocomial COVID-19 cases). Mothers (in both groups) and healthcare workers (in nosocomial cases) were the main source of infection. Hospital admission was required in 22 community-acquired cases [18 admitted to the neonatal intermediate care unit (NIMCU) and 4 to the neonatal intensive care unit (NICU)]. Among nosocomial COVID-19 cases (n = 14), previously admitted for other reasons, 4 were admitted to the NIMCU and 10 to the NICU. Ten asymptomatic patients were registered (5 in each group). In the remaining cases, clinical manifestations were generally mild in both groups, including upper respiratory airways infection, febrile syndrome or acute gastroenteritis with good overall health. In both groups, most severe cases occurred in preterm neonates or neonates with concomitant pathologies. Most of the cases did not require respiratory support. Hydroxychloroquine was administered to 4 patients in the community-acquired group and to 2 patients in the nosocomial group. Follow-up after hospital discharge was performed in most patients. Conclusions: This is the largest series of COVID-19 neonatal cases in Spain published to date. Although clinical manifestations were generally mild, prevention, treatment, and management in this group are essential.

show abstract

Section: Introductionmentioning

confidence: 95%

Neonatal Infection Due to SARS-CoV-2: An Epidemiological Study in Spain

et al. 2020

View full text Add to dashboard Cite

show abstract

“…A recent (as we write this commentary) review identified 27 publications describing 217 newborns born to mothers with COVID-19, of which 21 publications describing 187 newborns were from China. 3 Of the 217 newborns, 7 (3%) had evidence of SARS-CoV-2 infection: 3 had positive serum levels of immunoglobulin G and immunoglobulin M antibodies with negative polymerase chain reaction (PCR) test results, and 4 had positive PCR test results. Beyond the immediate postnatal period, in several case studies, authors report positive SARS-CoV-2 test results in symptomatic newborns in the first month of life, and new reports are published frequently.…”

mentioning

confidence: 99%

“…Beyond the immediate postnatal period, in several case studies, authors report positive SARS-CoV-2 test results in symptomatic newborns in the first month of life, and new reports are published frequently. [3][4][5][6][7] The mechanism of neonatal infection is unclear. Vertical transmission during pregnancy is not thought to be likely; SARS-CoV-2 test results on placenta, umbilical cord, amniotic fluid, vaginal secretions, and breast milk samples have uniformly been negative.…”

mentioning

confidence: 99%

Caring for Newborns Born to Mothers With COVID-19: More Questions Than Answers

2020

View full text Add to dashboard Cite

“…Hopefully, several extreme measures will not be needed, especially if very rapid and reliable tests become available. For the time being, it seems reasonable to use the available published COVID-19 NICU protocols [13][14][15], and increase surveillance when case-rates rise locally; unfortunately probably a necessary condition we will continue to face for some time.…”

mentioning

confidence: 99%

COVID-19 surveillance for all newborns at the NICU; conditio sine qua non?

2020

View full text Add to dashboard Cite

Previous studies have reported fewer cases of Coronavirus disease 2019 (COVID-19) in children than in adults, and to date there is limited literature about the clinical course and outcomes in neonates [1, 2]. Not inappropriately the focus of COVID-19 therapies has been in adults, especially the aged. However, it is clear that an immature immune system makes neonates, especially those in the NICU, highly vulnerable to infections generally [3, 4], and thus probably also for COVID-19. One case series has suggested that the younger the child, the higher risk of severe COVID-19 disease [5]. The first report of a neonate with COVID-19 infection was a 17 days old boy who recovered [6]. At the time of writing, complete data 1 on 35 neonates have been included in the database EPICENTRE [7]. Vertical risk was present in 33 neonates, and only two infants were reported to have community exposure. As more neonates are included in well-designed databases, the more we understand the risks, clinical spectrum, severity and complications in this patient population. Moreover, we can focus on ways to prevent COVID-19 infections in neonates born from an infected mother, or neonates that are infected in the community, whether at home, in hospital, by health care workers or families, especially during any potential new pandemic waves.

show abstract

COVID-19 and Neonatal Respiratory Care: Current Evidence and Practical Approach

Cited by 77 publications

References 59 publications

Neonatal Infection Due to SARS-CoV-2: An Epidemiological Study in Spain

Neonatal Infection Due to SARS-CoV-2: An Epidemiological Study in Spain

Caring for Newborns Born to Mothers With COVID-19: More Questions Than Answers

COVID-19 surveillance for all newborns at the NICU; conditio sine qua non?

Contact Info

Product

Resources

About