Reshaping neonatal intensive care units (NICUs) to avoid the spread of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) to high-risk infants

Rose, Domenico Umberto De; Auriti, Cinzia; Landolfo, Francesca; Capolupo, Irma; Salvatori, Guglielmo; Ranno, Stefania; Concato, Carlo; Braguglia, Annabella; Bagolan, Pietro; Dotta, Andrea

doi:10.1017/ice.2020.310

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…In many cases, the needed restrictions and containment measures (Cavicchiolo et al, 2020a , b ; De Rose et al, 2020 ) that are in place to deal with the COVID-19 emergency are exacerbating the problems associated with meager adoption of family-centered care principles in NICUs. During these months, it has been common to hear colleagues say that “COVID has made us go back decades in the quality of family support we provide.” This is a serious negative development because care should be all the more humane and person-centered during the COVID-19 pandemic; a goal that becomes fully achievable only through a strengthened involvement of patients' families (Coulter and Richards, 2020 ) and the support and empowerment of frontline healthcare workers.…”

Section: Supporting Persons and Strengthening Nicusmentioning

confidence: 99%

“…Despite understaffing being a significant risk factor for poor patient outcomes, it is infrequently addressed by interventions (Stapleton et al, 2016). In many cases, the needed restrictions and containment measures (Cavicchiolo et al, 2020a,b;De Rose et al, 2020) that are in place to deal with the COVID-19 emergency are exacerbating the problems associated with meager adoption of family-centered care principles in NICUs. During these months, it has been common to hear colleagues say that "COVID has made us go back decades in the quality of family support we provide."…”

Section: Strengthening Nicu Systemsmentioning

confidence: 99%

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The Collateral Impact of COVID-19 Emergency on Neonatal Intensive Care Units and Family-Centered Care: Challenges and Opportunities

et al. 2021

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The ongoing Coronavirus disease 2019 (COVID-19) pandemic is disrupting most specialized healthcare services worldwide, including those for high-risk newborns and their families. Due to the risk of contagion, critically ill infants, relatives and professionals attending neonatal intensive care units (NICUs) are undergoing a profound remodeling of the organization and quality of care. In particular, mitigation strategies adopted to combat the COVID-19 pandemic may hinder the implementation of family-centered care within the NICU. This may put newborns at risk for several adverse effects, e.g., less weight gain, more nosocomial infections, increased length of NICU stay as well as long-term worse cognitive, emotional, and social development. This article aims to contribute to deepening the knowledge on the psychological impact of COVID-19 on parents and NICU staff members based on empirical data from the literature. We also provided evidence-based indications on how to safely empower families and support NICU staff facing such a threatening emergency, while preserving the crucial role of family-centered developmental care practices.

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Section: Supporting Persons and Strengthening Nicusmentioning

confidence: 99%

Section: Strengthening Nicu Systemsmentioning

confidence: 99%

The Collateral Impact of COVID-19 Emergency on Neonatal Intensive Care Units and Family-Centered Care: Challenges and Opportunities

et al. 2021

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“…Concern should most be given to newborns that are premature, compromised, or carry potentially relevant risk factors. De Rose et al provide their account of necessary changes made to newborn care in a neonatal intensive care unit, whereas others have outlined a proposal for newborn emergency transport in this context [294,295]. Universal screening of newborns, parents, and healthcare workers in a neonatal intensive care unit has been assessed and has placed the burden of prevalent coronaviral infections on the associated adults [228].…”

Section: Mechanisms To Prevent Diseasementioning

confidence: 99%

A Comprehensive Analysis of Maternal and Newborn Disease and Related Control for COVID-19

Cimolai

2021

SN Compr. Clin. Med.

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The maternal-fetal/newborn unit is established at risk for COVID-19 infection. This narrative review summarizes the contemporary and cumulative publications which detail maternal infection, antenatal and newborn infections, and maternal/fetal/newborn management and prevention. There is a wide spectrum of maternal disease, but the potential for severe disease albeit in a minority is confirmed. COVID-19 carries risk for preterm delivery. Pregnant females can suffer multisystem disease, and co-morbidities play a significant role in risk. Congenital infection has been supported by several anecdotal reports, but strong confirmatory data are few. No typical congenital dysmorphisms are evident. Nevertheless, placental vascular compromise must be considered a risk for the fetus during advanced maternal infections. Clinical manifestations of newborn infection have been mild to moderate and relatively uncommon. Proven antiviral therapy is of yet lacking. The mode of delivery is a medical decision that must include patient risk assessment and patient directives. Both presymptomatic and asymptomatic mothers and offspring can complicate infection control management with the potential for spread to others in several regards. In the interim, infections of the maternal-fetal-newborn unit must be taken seriously both for the disease so caused and the potential for further dissemination of disease.

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“…8,21 Screening at NICU admission was assessed by authors from Padova and Rome. 31,32,53 Although the prevalence of COVID-19positive infants was low, both NICUs opted for a universal screening of newborns admitted to the Unit, their parents, and staff in order to avoid the spread of the virus in a high-risk ward. This policy allowed to identify early positive asymptomatic individuals, which were 2.2% of screened, 53 and it has been demonstrated as the best approach to reduce SARS-CoV-2-related costs.…”

Section: Postnatal Managementmentioning

confidence: 99%

Italian neonatologists and SARS-CoV-2: lessons learned to face coming new waves

et al. 2021

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The aim of this review was threefold: (a) to retrieve all SARS-CoV-2 evidences published by Italian neonatologists working in maternity centers and NICUs during the pandemic; (b) to summarize current evidence for the management of term and preterm infants with a SARS-CoV-2-related illness; and (c) to provide an update for dealing with the second wave of COVID-19 and discuss open questions. A review was conducted using MEDLINE/PubMed and the national COVID-19 registry of the Italian Society of Neonatology including citations from December 1, 2019 to October 28, 2020. Sixty-three articles were included. Collected data were divided into the following topics: (a) antenatal management, (b) management in delivery room, (c) postnatal management, (d) mother–baby dyad and breastfeeding management, (e) neonatal emergency transport system reorganization, (f) parents’ management and perspective during SARS-CoV-2 pandemic, and (g) future perspective. Evidences have evolved over the pandemic period and the current review can be useful in the management of the mother–neonate dyad during SARS-CoV-2 future waves. Italian neonatologists have played an active role in producing official guidelines and reporting data that have contributed to improve the care of neonates. A joint European action plan is mandatory to face COVID-19 in neonates with more awareness. Impact A joint European action plan is mandatory to face COVID-19 in neonates with more awareness. This review summarizes the available evidences from neonatal COVID-19 management in Italy analyzing all the published paper in this specific field of interest. The current review can be useful in the management of the mother–neonate dyad during the SARS-CoV-2 future waves.

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Reshaping neonatal intensive care units (NICUs) to avoid the spread of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) to high-risk infants

Cited by 6 publications

References 9 publications

The Collateral Impact of COVID-19 Emergency on Neonatal Intensive Care Units and Family-Centered Care: Challenges and Opportunities

The Collateral Impact of COVID-19 Emergency on Neonatal Intensive Care Units and Family-Centered Care: Challenges and Opportunities

A Comprehensive Analysis of Maternal and Newborn Disease and Related Control for COVID-19

Italian neonatologists and SARS-CoV-2: lessons learned to face coming new waves

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