COVID-19 in a Preterm- Leading to Remodelling of Care

Synthesis and systematic review of reported neonatal SARS-CoV-2 infections

“…Only two neonatal infections were diagnosed by the presence of IgM in newborn blood 29,82 : these cases qualified as possible congenital and probable postpartum acquired infections, respectively, according to the classification system 16 ; all the other cases had at least one positive RT-PCR. Nine (5.1%) neonates required delivery room resuscitation 19,20,38,41,44,69,77,87 and 67 (38.3%) needed to be admitted to the NICU 17,18,20,27,31,33,35,36,38,41,44,45,[47][48][49][51][52][53][57][58][59]61,62,[64][65][66][69][70][71][72][73]77,[80][81][82][85][86][87]<...>…”

“…Clinical features of neonatal SARS-CoV-2 infections. Ninetyseven neonates presented with clinical features related to COVID-19: 18,20,[26][27][28]30,32,[34][35][36][38][39][40][41]44,45,[50][51][52]55,56,58,60,61,[65][66][67][70][71][72]77,78,80,81,[85][86][87][88]90 their distribution is shown in Table 3. Respiratory manifestations mainly consisted of signs of respiratory failure, such as tachypnoea, intercostal retractions, and rhinitis; neonatal ARDS was not diagnosed in any case.…”

“…Laboratory abnormalities were evident in a minority of cases: 14 (14.4%) and 4 (4.1%) out of 97 neonates presented with lymphopenia 20,41,53,55,59,64,69,72,[79][80][81]88 and raised liver enzymes 35,72,79,88 , respectively. Inflammatory markers (Creactive protein and procalcitonin) were increased in 15 (15.5%) out of 97 neonates 20,27,38,40,43,45,49,59,70,72,[80][81][82]88 . Lung imaging was abnormal in 62 (64%) out of 97 neonates and consisted of an interstitialalveolar pattern at lung ultrasound or chest X-ray and ground-glass opacities at CT-scan 17,19,21,23,27,29,32,36,38,44,45,51,53,55,58,59,[64][65]…”

“…Inflammatory markers (Creactive protein and procalcitonin) were increased in 15 (15.5%) out of 97 neonates 20,27,38,40,43,45,49,59,70,72,[80][81][82]88 . Lung imaging was abnormal in 62 (64%) out of 97 neonates and consisted of an interstitialalveolar pattern at lung ultrasound or chest X-ray and ground-glass opacities at CT-scan 17,19,21,23,27,29,32,36,38,44,45,51,53,55,58,59,[64][65][66][69][70][71]73,[77][78][79][80]82,85,88,90 . One neonate presenting with neurological manifestations also showed bilateral gliosis of the deep white periventricular and subcortical matter, together with signs of cerebral vasculitis, which was not totally remitted at the hospital discharge 77 .…”

“…n.a. Kulkarni 49 Case report India PR 6 Good L'Huillier 50 Case series Switzerland PR 1 Low Lorenz 51 Case report Germany PR 6 Good Martinez-Peres 52 Case series Spain PR 1 Low Marzollo 53 Case report Italy PR 6 Good Meredith 54 Case series UK PR 1 Low Meslin 55 Case series France PR 6 Good Mithal 56 Case series USA PR 3 Intermediate Needleman 57 Case report USA PR 4 Intermediate Ng 58 Case series UK PR 6 Good Oncel 59 Case series Turkey PR 6 Good Paret 60 Case series USA PR 3 Intermediate Patanè 61 Case series Italy PR 6 Good Patil 62 Case series USA PR 4 Intermediate Pierce-Williams 63 Case series USA PR 5 Intermediate Piersigilli 64 Case report Belgium PR 6 Good Precit 65 Case report USA PR 5 Intermediate Salik 66 Case report USA PR 1 Low Salvatori 67 Case series Italy PR 6 Good Savasi 68 Case series Italy PR 1 Low Schwartz 69 Case series Iran PR 5 Intermediate Siddhi 70 Case report UK PR 3 Intermediate Sinelli 71 Case report Italy PR 6 Good Sisman 72 Case report USA PR 6 Good Sola 73 Case series Latin America b PR 5 Intermediate Sun D 74 Case report China PR 6 Good Sun 75 Case series China PR 6 Good Verma 76 Case series USA PR 2 Low Vivanti 77 Case report France PR 6 Good Wang 78 Case report China PR 6 Good Wang X 79 Case report China PR 6 Good Wardell 80 Case series USA PR 6 Good White 81 Case series USA PR 6 Good Wu 82 Case series China PR 5 Intermediate Xia 83 Case series China PR 4 Intermediate Xiao 84 Cross-sectional study China PR n.a. Intermediate Yu…”