ABSTRACT
The interest in wearable wireless monitoring systems has accelerated secondary to the ongoing COVID-19 pandemic. Moreover, the alarmingly high number of infections in the pediatric population underscores a gap in monitoring these vulnerable populations, particularly in the home setting. This systematic review aims to identify and assess currently available wearables used to monitor cardiopulmonary function in infants and neonates. The study, prospectively registered on PROSPERO (CRD42020200642), completed a search of PubMed 1946-, Embase 1947-, Cochrane Library, Scopus 1823-, and IEEE Explore 1872-in June 2020. A total of 2324 unique citations were identified, with 16 studies describing 17 unique devices meeting inclusion criteria. Types of devices included smart clothing, belts, and mechanical adhesives, each with unique battery designs, data collection, and transmission hardware. Only four of the 17 devices underwent rigorous comparative testing, and three demonstrated correlation with the standard of care monitoring systems. Low sensitivity and specificity were reported in two commercially available consumer devices compared to the standard of care monitoring systems. The risk of bias in the entire cohort was highly based on a modified ROBINS-I scale. Further development and rigorous wearable device testing are necessary for neonatal and infant deployment.
ABSTRACT
The novel coronavirus disease 2019 (COVID-19) pandemic has urged the development and implementation of guidelines and protocols on diagnosis, management, infection control strategies, and discharge planning. However, very little is currently known about neonatal COVID-19 and severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infections. Thus, many questions arise with regard to respiratory care after birth, necessary protection to health care workers (HCW) in the delivery room and neonatal intensive care unit (NICU), and safety of bag and mask ventilation, noninvasive respiratory support, deep suctioning, endotracheal intubation, and mechanical ventilation. Indeed, these questions have created tremendous confusion amongst neonatal HCW. In this manuscript, we comprehensively reviewed the current evidence regarding COVID-19 perinatal transmission, respiratory outcomes of neonates born to mothers with COVID-19 and infants with documented SARS-CoV-2 infection, and the evidence for using different respiratory support modalities and aerosol-generating procedures in this specific population. The results demonstrated that to date, neonatal COVID-19 infection is uncommon, generally acquired postnatally, and associated with favorable respiratory outcomes. The reason why infants display a milder spectrum of disease remains unclear. Nonetheless, the risk of severe or critical illness in young patients exists. Currently, the recommended respiratory approach for infants with suspected or confirmed infection is not evidence based but should include all routinely used types of support, with the addition of viral filters, proper personal protective equipment, and placement of infants in isolation rooms, ideally with negative pressure. As information is changing rapidly, clinicians should frequently watch out for updates on the subject. KEY POINTS: · Novel coronavirus disease 2019 (COVID-19) pandemic urged development of guidelines.. · Neonatal COVID-19 disease is uncommon.. · Respiratory outcomes in neonates seems favorable.. · Current neonatal respiratory care should continue.. · Clinicians should watch frequently for updates..