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Backgrounds: The clinical and socioeconomic effects of COVID-19 are still being felt through-out the world. The disease affects people of all age groups, but it is known to have a milder clinical course in children including neonates. There is paucity of data from Sub-Saharan Africa on neonatal COVID-19 infection, and no such case has been reported in the literature in Ghana. Case presentation: This study presented a case report of a neonate who was found to be positive for COVID-19 infection after presenting symptoms such as respiratory distress, rhinorrhoea, and cough. This neonate was managed with in-hospital standard protocol for sepsis with a focus on pneumonia. Conclusion(s): The national guidelines on COVID-19 management were used for the neonate who was recovered and discharged.Copyright © 2021, TMU Press.
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COVID-19 has affected the population worldwide drastically with a tremendous impact on obstetric population which has led to serious concerns regarding maternal and fetal outcomes. Although there are recommended guidelines regarding delivery and management of complications, due to changes in characteristics of COVID-19 infection, they are constantly changing and evolving. Method(s): Prospective cohort study done during the covid pandemic from 1st April 2020 to 15th Feb 2022 in the department of Obstetrics & Gynecology, SKIMS MCH Srinagar J&K. The parameters measured were severity of covid disease, maternal age, gestational age, parity, blood investigations, mode of delivery, APGAR score, neonatal infection status and post-delivery complications. Result(s): A total of 311 pregnant covid 19 positive patients were included in the study who were actively managed.239 (76.85%) were delivered by casearean section and 72 (23.15%) by NVD. 92% patients had mild symptoms only, 8% had severe symptoms with 1.6% rate of ICU admission and 1.2% mortality rate. 83% delivered at term, 17% had preterm deliveries.8% patients had pneumonitis with positive findings on CT scan.24% patients had anemia, 12% had GDM, 10% had PIH, 10% had IHCOP, 5% had PPH, 1.6% had APH. All the neonates were negative for covid 19. 80% babies had an APGAR score of >= 8/10 at 1 min of birth with a mean birth weight of 2400 g +/- 500. No postdelivery complication was noted. Conclusion(s): Our study concludes that SARS-CoV-2 infection can lead to unfavorable maternal and perinatal outcomes.
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The incidence of the new coronavirus infection (COVID-19) remains a global problem worldwide. However, the effect of COVID-19 on the course of pregnancy and the possibility of intrauterine infection are insufficiently investigated. Recent studies suggest the possibility of a transplacental transmission of infection caused by SARS-CoV-2. Goal: To analyze SARS-Cov-2 RNA detection cases in newborns and to study possible factors influencing the infection of newborns from mothers with COVID-19. Materials and methods. From March to August 2020, there were 64 births to women with a confirmed diagnosis of COVID-19 at the Botkin's Infection Disease Hospital. In 15 newborns, the diagnosis of COVID-19 was laboratory confirmed. In this study, the histories of 14 newborns and their mothers were analyzed retrospectively. The diagnosis of COVID-19 was based on the detection of SARS-Cov-2 RNA in a nasopharyngeal swab or in fecal samples. Results. Analysis of the histories of mothers showed that 4 (28.6%) patients had an asymptomatic disease. Three (21.4%) women had a severe course of COVID-19, 7 (50%) patients had a course of moderate severity. Fetal hypoxia was more common in women with severe or moderate course of COVID-19. In 6 (42.7%) newborns, a positive nasopharyngeal swab was obtained within 48 hours after birth. None of the women whose children were RNA-positive in the first two days had a severe form of the disease, and two patients had an asymptomatic disease. Conclusion. 1. The frequency of detection of SARS-CoV-2 RNA in newborns from mothers with COVID-19 (under mother-child separation) was 21.9%. 2. Infection of a newborn with SARS-CoV-2 is possible both with a severe course of the disease in the mother and with an asymptomatic course. 3. A caesarean section does not exclude the possibility of a newborn infection with SARS-CoV-2. 4. In newborns, in most cases, an asymptomatic course of COVID-19 is observed.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
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Aim: Coronavirus disease 2019 (COVID-19) pandemic is an ongoing emergency with limited data on perinatal outcomes. The aim of the study was to describe key maternal, perinatal, and neonatal outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection from low–middle income settings. Materials and methods: We conducted a retrospective observational study in a tertiary level public hospital in India. All pregnant women admitted from May 2020 to July 2020 were included in the study. Maternal demography, medical and obstetric complications, clinical characteristics, and investigations were described. Symptomatic infected women were compared with the asymptomatic group for important outcomes. Key perinatal outcomes such as early pregnancy losses, fetal distress, stillbirths, and placental changes were evaluated. Neonatal characteristics of SARS-CoV-2 positive and negative pregnancies were described and compared. Results: Among the 702 pregnant women enrolled, the incidence of SARS-CoV-2 infection was 16.2%, with the majority being asymptomatic. Infected women had an increased mortality, while symptomatic women had a significant risk of stillbirth. Mean placental weight of infected women was significantly higher. Neonatal infection rate was 9.1%, with 50% manifesting mild respiratory symptoms without any mortality. Conclusion: This study provides a comprehensive description of important antenatal, intrapartum and neonatal complications and outcomes in a low–middle income setting characterized by high disease burden and an overwhelmed health care system. Clinical significance: Incidence of SARS-CoV-2 infection in pregnancy was 16.2%. The symptomatic infected women had increased stillbirth and mortality. Neonatal transmission was seen in 9.1% with good survival.
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Introduction: The COVID-19 pandemic has been widely described, however, there is limited data regarding neonatal infection. We present an extremely premature neonate with suspected COVID-19 pneumonia treated with Remdesivir. Case Description: Our patient is an infant born via emergency cesarean section for chorioamnionitis at 24 weeks gestational age with extremely low birth weight (ELBW). Mother is a 23-yearold primigravid female whose pregnancy was complicated by asymptomatic COVID-19 infection diagnosed by nasopharyngeal PCR ten days prior to delivery. Antenatal steroids were given for imminent premature delivery. Infant was intubated during initial resuscitation then extubated to non-invasive positive pressure ventilation (NIPPV) on day three of life. On day seven of life, she developed increasing apneic spells and feeding intolerance. Empiric antibiotics were initiated while awaiting blood and cerebrospinal fluid cultures. Blood culture grew Serratia marcescens and antibiotic coverage was tailored to cefepime monotherapy. Our patient remained stable on non-invasive respiratory support seven days into her sepsis event. Around this time, histopathological analysis of the placenta revealed acute villitis and intervillositis highly suggestive of COVID-19 placentitis. A positive nasopharyngeal COVID-19 PCR was noted on day ten of life. Our patient remained stable on non-invasive respiratory support until day fourteen of life, when she suddenly developed refractory hypoxemia requiring intubation. This coincided with acute changes in her chest x-ray (Fig 1). The negative bacterial respiratory culture, timing of clinical deterioration, and placental findings increased our suspicion for symptomatic co-infection with COVID-19. Patient continued to have refractory hypoxia and poor ventilation despite maximum settings and inhaled nitric oxide. After an extensive multidisciplinary discussion, patient received Remdesivir as a compassionate measure. Neonatal dosage was well tolerated with no adverse effects at 5 mg/kg loading dose followed by four days of maintenance dosing at 2.5 mg/kg. Significant clinical improvement was noted after the second day by decreasing FiO2 requirements. COVID-19 PCR remained positive ten days after Remdesivir treatment was completed. Patient was extubated to NIPPV on day thirty-six of life and is currently requiring no respiratory support at 37 weeks corrected age. Discussion: We present an ELBW neonate with placental findings typical of COVID-19 infection and refractory hypoxemia likely due to COVID-19 pneumonia. To date, the mechanism for this infant's infection is unclear. Based on the Acharya et al. Classification for Maternal-Fetal-Neonatal SARS-CoV-2 infection, our patient fits into probable neonatal infection acquired post-partum category. We have strong evidence of infection but lack of absolute proof to confirm congenital disease as no testing was done at birth. We acknowledge that part of the clinical course was complicated by sepsis, however, the peak of illness correlates with the typical clinical course for COVID-19 infection. Conclusion: To our knowledge, this may be the youngest patient documented to have COVID-19 pneumonia and received Remdesivir treatment.
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The frequency of COVID-19 infection in neonates and the management and outcome of SARS-CoV in this age group is a field that is, as yet, poorly docu-mented. This review summarizes the current literature regarding the clinical characteristics, management and outcome of neonates with confirmed CO-VID-19. Current evidence shows that COVID-19 rarely affects neonates severely, with most cases being asymptomatic, while the most commonly reported clinical symptom is respiratory distress. The clinical characteristics of pregnant women with COVID-19 infection are similar to those of non-pregnant adult patients with COVID-19. Neonates born to mothers who are categorized as either diagnosed cases, or suspected cases of COVID-19, should be treated according to the latest guidelines. It is of great importance to conduct large-scale, well-designed cohort studies, in order to better understand the impact of COVID-19 on neonatal health.
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Background. Since the beginning of the SARS-CoV-2 pandemic, most neonatal units around the world have restricted parents’ access, aiming to protect the staff and the babies against the infection. Objective. To evaluate the side effects of the limitation of parents presence with their babies in neonatal units and those related to restrictions on maternity wards access. Method. Literature review. A search using ‘SARS-CoV-2’ and ‘COVID-19’ as keywords combined to ‘neonatal’, ‘NICU’, ‘parents’, ‘family centered care’ and ‘neurodevelopmental care’. Consultation of websites containing updated and summarized scientific literature about the pandemic and its consequences in newborns has also been performed: www.dontforgetthebubles.com and www.seneo.es. The voice of the families has been mainly obtained through the websites of their associations and the social networks. Results. The family-centered care model has shown positive effects on the health of sick newborns and on premature infants’ neurodevelopment. This model of care is under threat if parental access is limited. It has been shown that these restrictions have also adverse effects on breastfeeding and on caregivers’ psychological wellbeing. Data from different neonatal series report a benign course of COVID-19 infection in neonates and preterm babies. Conclusions. At a crucial moment for the implementation of the developmental centered care model in Catalan neonatal units, and with the available data, it is essential to redesign the policies regarding parents who accompany their babies admitted to the units.
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Background: The COVID-19 pandemic has changed the paradigm when it comes to infection control. However, there are still many doubts about pregnancy and the perinatal period in this context, even though many studies suggest the benignity of infection in this phase. The present study took place in a Level II Hospital with differentiated perinatal care and describes the newborns whose mothers were infected with COVID-19 during pregnancy. We aim to understand the mother-newborn pattern of transmission and clinical, analytical and serologic follow-up. Methods: Prospective observational study from 1/4/2020 to 31/5/2021, using the clinical files of every SARS-COV-2 PCR-positive mother and their newborns. Among others, we evaluated the state of infection of the newborn at 12 and 48h and after 14 days with SARS-Cov-2 PCR tests. In the first three months, serologic and clinical evaluation were performed. Results: Of the 1684 live births, 60 (3,6%) mothers were infected with SARS-COV-2 during pregnancy, 43% of which were diagnosed in the screening performed during/before labour. The median value of gestational age was 39 weeks, and the average weight was 3171g. 81,7% of the newborns remained with their mother in the hospital ward, and 85% were breastfed. 7 newborns (11,7%) needed NICU, one of which was born at 32 weeks because the mother needed ICU support due to COVID-19. Of the 26 newborns whose mothers were positive in labour, 15 were tested for SARS-Cov-2 PCR in the first 12 h, and 21 within 48h: all of them were negative.16 were tested after 14 days. Only one of them (6,2%) tested positive but remained asymptomatic. Serologic anti-spike and anti-nucleocapsid analyses were performed in 32 babies: 10 of them (31.3%) showed positive antibodies. In these cases, 80% of the mothers were positive in the 3rd trimester and 20% in the 2nd trimester. The clinical follow-up showed a positive outcome in all of them. Conclusions: This study supports others that show the benignity of perinatal SARS-COV-2 infection. There were no more significant rates of prematurity or NICU need. None of the newborns tested positive in SARS-Cov-2 PCR tests in the first 48h, supporting the rarity of the vertical infection, and only one has been affected by horizontal transmission.