Hyperglycemia and Cytopenias as Signs of SARS-CoV-2 Delta Variant Infection in Preterm Infants

Boly, Timothy J.; Reyes-Hernandez, Melanie E.; Daniels, Elizabeth C.; Kibbi, Nadine; Bermick, Jennifer; Elgin, Timothy G.

doi:10.1542/peds.2021-055331

Cited by 4 publications

(4 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, a case report suggested that SARS-CoV-2 infection can cause hyperglycemia in preterm infants [24]. Similarly, reports on adults also found increased risk † Te efect estimate for all outcomes was obtained by comparing exposed vs. non-exposed cohorts.…”

Section: Discussionmentioning

confidence: 97%

Impact of Perinatal Exposure to SARS-CoV-2 Infection on Early Health Outcomes among Infants Born from 2020 to 2021 in British Columbia, Canada

Richter

Zhang

et al. 2023

Canadian Journal of Infectious Diseases and Medical Microbiolog

View full text Add to dashboard Cite

Background. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has impacted healthcare services and outcomes. We aimed to investigate healthcare resource utilization and early health outcomes of infants born to mothers with perinatal SARS-CoV-2 infection. Methods. The study included all infants born alive between February 1, 2020, and April 30, 2021, in British Columbia. We used linked provincial population-based databases including data on COVID-19 testing, birth, and health information for up to one year from birth. Perinatal COVID-19 exposure for infants was defined being born to mothers with a positive test for SARS-CoV-2 infection during pregnancy or at delivery. Cases of COVID-19-exposed infants were matched with up to four non‐exposed infants by birth month, sex, birthplace, and gestational age in weeks. Outcomes included hospitalizations, emergency department visits, and in-/outpatient diagnoses. Outcomes were compared between groups using conditional logistic regression and linear mixed effects models including effect modification by maternal residence. Results. Among 52,711 live births, 484 infants had perinatal exposure to SARS-CoV-2, an incidence rate of 9.18 per 1000 live births. Exposed infants (54.6% male) had a mean gestational age of 38.5 weeks, and 99% were born in hospital. Proportions of infants requiring at least one hospitalization (8.1% vs. 5.1%) and at least one emergency department visit (16.9% vs. 12.9%) were higher among the exposed vs. unexposed infants, respectively. Among infants from the urban area, those with exposure were more likely to have respiratory infectious diseases (odds ratio: 1.74; 95% confidence intervals: 1.07, 2.84), compared with those without exposure. Interpretation. In our cohort, infants born to mothers with SARS-CoV-2 infection have increased healthcare demands in their early infancy, which warrants further investigation.

show abstract

Section: Discussionmentioning

confidence: 97%

Impact of Perinatal Exposure to SARS-CoV-2 Infection on Early Health Outcomes among Infants Born from 2020 to 2021 in British Columbia, Canada

Richter

Zhang

et al. 2023

Canadian Journal of Infectious Diseases and Medical Microbiolog

View full text Add to dashboard Cite

show abstract

“…However, thrombocytopenia tended to worsen and required close monitoring. Although SARS-CoV-2 infection does not typically cause cytopenia or hyperglycemia as seen in preterm infants [8], these complications can still occur in children [9]; therefore, it is unwise to assume that they are less common.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 Infection Mimicking Neutropenic Fever during Chemotherapy for Acute Lymphoblastic Leukemia: A Case Report

Kang

2023

Clin Pediatr Hematol Oncol

View full text Add to dashboard Cite

Children with SARS-CoV-2 infection typically exhibit mild respiratory symptoms, with only a small proportion presenting with gastrointestinal symptoms. However, children and adolescents with cancer may develop severe illnesses when infected with respiratory viruses. Most patients are asymptomatic or have mild-to-moderate infections, but a significant percentage face severe or critical COVID-19-related illnesses. Diagnosing SARS-CoV-2 in pediatric patients is challenging because of frequent asymptomatic cases or those presenting with only a fever. In pediatric patients with SARS-CoV-2, heightened inflammatory markers and coagulation abnormalities are common. Increased levels of inflammatory markers and lymphopenia are risk factors for severe illness, making essential blood tests crucial as potential indicators of disease severity. Febrile neutropenia (FN), a common and potentially fatal side effect of chemotherapy, occurs in roughly 50% of children receiving cancer chemotherapy, and individuals with FN should remain vigilant for SARS-CoV-2 infection, even with mild symptoms. COVID-19-related fatalities occur in 4% of pediatric patients, which is significantly lower than the 25% observed in adult cancer patients but disproportionately higher than the 0.5% mortality rate among general pediatric cohorts. The case of a 12-year-old boy with neutropenic fever undergoing intensive anticancer therapy who was later confirmed to have SARS-CoV-2 infection highlights the importance of vigilance in such patients.

show abstract

“…98 Even in full-term newborns during the Omicron period, neonates born to infected mothers had an increased risk of lower birth weight, lower Apgar scores, and an increased risk for respiratory support until 12 hours after birth when compared with those born to mothers without infection. 99 Boly et al 100 described three premature newborns from women with confirmed Delta infection with very low birth weight (<1500 g) and reported that all three infants presented with hyperglycemia and bone marrow dysfunction. Delta variants also seem to affect children to a greater extent than other variants.…”

Section: Perinatal Mortality and Morbiditymentioning

confidence: 99%

Maternal and Perinatal Outcomes of SARS-CoV-2 and Variants in Pregnancy

et al. 2023

View full text Add to dashboard Cite

Pregnancy is a physiological state that predisposes women to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, a disease that can cause adverse maternal and perinatal outcomes. The severity of coronavirus disease 2019 (COVID-19) disease is known to vary by viral strain; however, evidence for the effects of this virus in pregnant women has yet to be fully elucidated. In this review, we describe maternal and perinatal outcomes, vaccination, and vertical transmission, among pregnant women infected with the different SARS-CoV-2 variants identified to date. We also summarize existing evidence for maternal and perinatal outcomes in pregnant women with specific information relating to SARS-CoV-2 variants. Our analysis showed that Omicron infection was associated with fewer severe maternal and perinatal adverse outcomes while the Delta variant was associated with worse pregnancy outcomes. Maternal deaths arising from COVID-19 were found to be rare (<1.0%), irrespective of whether the virus was a wild-type strain or a variant. Severe maternal morbidity was more frequent for the Delta variant (10.3%), followed by the Alpha (4.7%), wild-type (4.5%), and Omicron (2.9%) variants. The rates of stillbirth were 0.8%, 4.1%, 3.1%, and 2.3%, respectively, in pregnancies infected with the wild-type strain, Alpha, Delta, and Omicron variants, respectively. Preterm birth and admission to neonatal intensive care units were more common for cases with the Delta infection (19.0% and 18.62%, respectively), while risks were similar for those infected with the wild-type (14.7% and 11.2%, respectively), Alpha (14.9% and 13.1%), and Omicron variants (13.2% and 13.8%, respectively). As COVID-19 remains a global pandemic, and new SARS-CoV-2 variants continue to emerge, research relating to the specific impact of new variants on pregnant women needs to be expanded.

show abstract

Hyperglycemia and Cytopenias as Signs of SARS-CoV-2 Delta Variant Infection in Preterm Infants

Cited by 4 publications

References 20 publications

Impact of Perinatal Exposure to SARS-CoV-2 Infection on Early Health Outcomes among Infants Born from 2020 to 2021 in British Columbia, Canada

Impact of Perinatal Exposure to SARS-CoV-2 Infection on Early Health Outcomes among Infants Born from 2020 to 2021 in British Columbia, Canada

SARS-CoV-2 Infection Mimicking Neutropenic Fever during Chemotherapy for Acute Lymphoblastic Leukemia: A Case Report

Maternal and Perinatal Outcomes of SARS-CoV-2 and Variants in Pregnancy

Contact Info

Product

Resources

About