Coronavirus Infection in Neonates: Neurodevelopmental Outcomes at 18 Months of Age.

Background: Although most neonates with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection experience only mild disease, its impact on neurodevelopmental outcomes is unknown. This study aimed to assess the 18-month neurodevelopmental outcomes of infants who had SARS-CoV-2 infection as neonates. Methods: The authors conducted a prospective cohort study of neonates diagnosed with SARS-CoV-2 infection from June 2020 to December 2020 through nasopharyngeal coronavirus disease 2019 (COVID-19). A total of 58 neonates were identified from the Kuwait National COVID-19 Registry and enrolled. Historical controls were selected from the neonatal follow-up registry and matched in a 2 : 1 ratio based on sex and gestational age. When the subjects were 18 months of age, their neurodevelopmental outcomes were assessed by two trained assessors using the Bayley Scales of Infant and Toddler Development-3rd Edition (BSID-III). Results: Forty children diagnosed with SARS-CoV-2 infection were included in the final analysis. The median age at infection was 18 days (range: 10-26 days). Eighteen (45%) patients were asymptomatic, 15 (37.5%) had a sepsis-like presentation, 5 (12.5%) exhibited respiratory distress, and 2 (5%) had a multisystem inflammatory syndrome in children (MIS-C)-like presentation. At the 18 months follow-up, only one child showed a severe developmental delay and one child had a language delay. BSID-III outcomes did not differ significantly between the SARS-CoV-2-infected and control groups. Conclusions: There was no difference in neurodevelopmental outcomes at 18 months in children infected with SARS-CoV-2 compared with controls, although longer neurodevelopmental follow-up studies are required.

Neurodevelopmental outcomes of infants born to mothers with SARS-CoV-2 infections during pregnancy: a national prospective study in Kuwait.

BACKGROUND: An increasing proportion of women are infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy. Intrauterine viral infections induce an increase in the levels of proinflammatory cytokines, which inhibit the proliferation of neuronal precursor cells and stimulate oligodendrocyte cell death, leading to abnormal neurodevelopment. Whether a maternal cytokine storm can affect neonatal brain development is unclear. The objective of the present study was to assess neurodevelopmental outcomes in neonates born to mothers with SARS-CoV-2 infections during pregnancy. METHODS: In this prospective cohort study, the neurodevelopmental status of infants (N = 298) born to women with SARS-CoV-2 infections during pregnancy was assessed at 10-12 months post-discharge using the Ages and Stages Questionnaire, 3rd edition (ASQ-3). The ASQ-3 scores were classified into developmental delays (cutoff scores ≤ 2 standard deviations (SDs) below the population mean) and no delays (scores > 2 SDs above the population mean). RESULTS: The majority (90%) of the infants born to mothers with SARS-CoV-2 infections during pregnancy had favorable outcomes and only 10% showed developmental delays. Two of the 298 infants tested positive for SARS-CoV-2, and both had normal ASQ-3 scores. The majority of the pregnant women had SARS-CoV-2 infections during their third trimester. The risk of developmental delays among infants was higher in those whose mothers had SARS-CoV-2 infections during the first (P = 0.039) and second trimesters (P = 0.001) than in those whose mothers had SARS-CoV-2 infections during the third trimester. CONCLUSION: The neurodevelopmental outcomes of infants born to mothers with SARS-CoV-2 infections seem favorable. However, more studies with larger sample sizes and longer follow-up periods are required.

Type 1 Diabetes (T1D) Onset and COVID-19-Effect of the Second Wave on Diabetes Ketoacidosis and ICU Admission Rates in Newly Diagnosed Children with T1D in Kuwait

Introduction: The COVID-19 pandemic had affected access to healthcare services around the globe. On February 24th, 2020, the first wave of the pandemic was announced. The government of Kuwait had implemented public health measures including curfews, nationwide lockdowns, and limited access to healthcare services. The second wave was declared on March 7, 2021;virtual visits, availability of diabetes clinics, and easier access to healthcare facilities may change the frequency of diabetes ketoacidosis (DKA) and the requirement for ICU admission for children with type 1 diabetes (T1D) onset in the second wave. Aims: To evaluate DKA at presentation and ICU admission among children with T1D onset during the first and second waves using data from Childhood Onset Diabetes electronic Registry (CODeR) . Methods: Data were extracted from CODeR. Included patients were aged less than 14 years at the time of T1D diagnosis in the period (February 24th - December 31st, 2021) , and in the same period in 2020. Results: Between February and December 2021, 253 children were identified to have T1D onset, compared with 282 during the same period in 2020. There were no significant differences between HbA1c levels (11.41% vs. 11.56%;p value=0.21) and frequency of DKA in both groups (56.4% vs. 54%, p value=0.51) . Mild/moderate DKA rates didn't differ in both periods (66.1% vs. 60.7%, p value=0.42) , and Severe DKA as well (33.9% vs. 39.3%, p value=0.42) . No significant difference in ICU admission rates was observed in both periods (25.5% vs. 23.9%,p value=0.74) . Conclusion: The second wave of the COVID-19 pandemic didn't change DKA frequency or the requirement of ICU admission compared to the first wave. Further studies investigating the frequency of DKA, ICU admission, and other factors are needed over longer periods to evaluate how the COVID-19 pandemic affects DKA changes as the pandemic continues.