Novel Coronavirus disease (COVID-19) in newborns and infants: what we know so far

Abstract

Recently, an outbreak of viral pneumonitis in Wuhan, Hubei, China successively spread as a global pandemia, led to the identification of a novel betacoronavirus species, the 2019 novel coronavirus, successively designated 2019-nCoV then SARS-CoV-2). The SARS-CoV-2 causes a clinical syndrome designated coronavirus disease 2019 (COVID19) with a spectrum of manifestations ranging from mild upper respiratory tract infection to severe pneumonitis, acute respiratory distress syndrome (ARDS) and death. Few cases have been observed in children and adolescents who seem to have a more favorable clinical course than other age groups, and even fewer in newborn babies. This review provides an overview of the knowledge on SARS-CoV-2 epidemiology, transmission, the associated clinical presentation and outcomes in newborns and infants up to 6 months of life.

Managing COVID-19-Positive Maternal–Infant Dyads: An Italian Experience

“…1 Although children seem to have a milder disease than adults, newborns and infants could be more at risk than other pediatric categories; thus, they deserve special attention because of insidious and nonspecific symptoms. 2 Although there is currently no evidence showing a vertical transmission of SARS-CoV-2 infection in fetuses of women developing COVID-19 pneumonia in late pregnancy, 3 a major concern involves the possible transmission of the infection to their fragile infants, in particular after delivery. The virus can be detected by real-time polymerase chain reaction (RT-PCR) in different biological fluids (bronchoalveolar-lavage fluid, sputum, saliva, nasopharyngeal swabs, and feces) but no positive breast milk samples have been found in different reported cohorts for a total number of 32 dyads.…”

“…The virus can be detected by real-time polymerase chain reaction (RT-PCR) in different biological fluids (bronchoalveolar-lavage fluid, sputum, saliva, nasopharyngeal swabs, and feces) but no positive breast milk samples have been found in different reported cohorts for a total number of 32 dyads. 2 Therefore, for COVID-19-positive new mothers, whenever possible, it is advisable to plan a joint management of the mother with her infant, to promote the beginning of breastfeeding, while assessing on a case-by-case basis if eventual drugs administered to infected mothers could be harmful to the infant. According to the indications of the Italian Society of Neonatology, 4 if a mother previously identified as COVID-19 positive is asymptomatic or paucisymptomatic, rooming-in is a reasonable management and direct breastfeeding is prudent, ensuring strict measures of infection control (washing often mother's hands before touching the infant and wearing a face mask).…”

“…We analyzed expressed breast milk samples of both mothers, and SARS-CoV-2 was not detected by RT-PCR, as already described. 2 Virus detection analysis after pasteurization was not performed because the virus was not found already in expressed milk.…”

Perinatale Aspekte der SARS-CoV-2 Infektion

“…Somit stellt sich der neonatale Verlauf bei Kindern von COVID-19-positiven Müttern in den meisten Fällen milde bis asymptomatisch dar. Die Sorge vor rascher respiratorischer Verschlechterung in Einzelfällen sowie die eingeschränkten Behandlungsmöglichkeiten lassen Neugeborene von COVID-19-positiven Müttern jedoch als Risikogruppe einstufen 14 .…”

“…Eine vertikale Transmission von Mutter zum Kind wird diskutiert 5 6 7 8 9 . Berichte zu Infektionen von Schwangeren 6 7 8 10 , sowie peri- und postnatale Infektionen 11 12 13 14 werden zunehmend publiziert. Es besteht weiterhin große Unsicherheit betreffend der materno-fetalen Transmission, dem Infektionsverlauf bei Schwangeren, dem Risiko für Frühgeburten sowie dem postnatalen Verlauf.…”