ABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID-19) can be more severe in infants than in older children. To date, only a few case series have reported data on neonates with COVID-19, including mostly asymptomatic neonates who were tested because of exposure to maternal SARS-CoV-2 infection. This study summarises nationwide epidemiological data, clinical characteristics, treatment and outcomes of neonates presenting with symptomatic SARS-CoV-2 infection. METHODS: Data were prospectively collected through the Swiss Paediatric Surveillance Unit from hospitalised neonates with laboratory-confirmed SARS-CoV-2 infection (positive polymerase chain reaction on a respiratory sample) from 1 March 2020 to 31 September 2021. All 29 paediatric hospitals in Switzerland reported cases. RESULTS: In total, 73 neonates were included; 7 (10%) were preterm. The median age at presentation was 17 days (interquartile range [IQR] 11-23); 40 (55%) were female. The majority of neonates (64, 88%) were admitted from home. Nine (12%) had a pre-existing medical condition. Overall, the most common symptom recorded was fever in 52 (71%), followed by rhinorrhoea or nasal congestion in 32 (44%) and respiratory distress in 19 (26%). Twenty (27%) neonates presented with fever without a source. Seven (10%) neonates were admitted to an intensive care unit (5 for respiratory failure and 2 for monitoring). One (1%) neonate required inotropic support. The median length of hospital stay in term neonates was 4 days (IQR 3-5). Two (3%) were treated with corticosteroids and 1 (1%) with remdesivir. In total, 60 (82%) neonates had contact with a known or suspected SARS-CoV-2 index case. All of the 71 neonates for whom data were available were discharged to their homes without symptoms. CONCLUSION: In neonates, COVID-19 mainly presents with fever, and symptoms of upper and lower respiratory tract infection. The clinical course is mostly mild, requiring a short period of hospitalisation. COVID-19 needs to be added as a differential diagnosis in neonates who present with fever without a source. However, the presence of SARS-CoV-2 should not deter from the search for a serious bacterial infection. Further data from surveillance studies are needed to better understand COVID-19 in neonates, guide therapy and to evaluate whether the clinical spectrum is changing with new SARS-CoV-2 variants.
Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , Child , Female , Fever/epidemiology , Fever/etiology , Humans , Infant , Infant, Newborn , Intensive Care Units , Male , Prospective StudiesABSTRACT
In anticipation of an interseasonal respiratory syncytial virus (RSV) epidemic, a clinician-led reporting system was rapidly established to capture RSV infections in Swiss hospitals, starting in January 2021. Here, we present details of the reporting system and first results to June 2021. An unusual epidemiology was observed with an interseasonal surge of RSV infections associated with COVID-19-related non-pharmacological interventions. These data allowed real-time adjustment of RSV prophylaxis guidelines and consequently underscore the need for and continuation of systematic nationwide RSV surveillance.
Subject(s)
COVID-19 , Respiratory Syncytial Virus Infections , Respiratory Syncytial Virus, Human , Respiratory Tract Infections , Humans , Infant , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Virus Infections/prevention & control , SARS-CoV-2 , Switzerland/epidemiologyABSTRACT
Sexism and gender inequalities are well-known issues in medical community and hospitals are also concerned. The Swiss Junior Doctors Association, local branch (canton of Vaud) conducted a survey about this topic. 44% of participants (67-186 junior doctors answered the survey) have been victims or witnessed sexist remarks. 76% heard hostiles speeches about pregnancy. 62% of pregnant women did not benefit from measures provided by Swiss law. 82 % of mothers experienced pregnancy as a career-limiting event. Human resources and management have responsibility for reporting discriminatory behavior and taking appropriate actions. Having children should be valued and pregnant women protected according to Swiss law, which should be enforced without conditions.
La question du sexisme et de l'inégalité de genre est connue en milieu médical et les hôpitaux romands ne sont pas épargnés. L'Association suisse des médecins assistant·e·s et chef·fe·s de clinique, Section Vaud, a soumis à ses membres un sondage sur ce thème. 44 % des répondant·e·s (67 à 186 participant·e·s selon les questions) ont été victimes/témoins de remarques sexistes. 76 % ont entendu des discours hostiles à la grossesse. 62 % des femmes enceintes n'ont pas bénéficié des mesures prévues par la Loi sur le Travail (LTr). 82 % des mères vivent la maternité comme un frein à la carrière. Les ressources humaines et directions ont la responsabilité d'encourager la dénonciation des comportements problématiques et de prendre des mesures. Le projet familial doit être valorisé et la protection de la grossesse, réglée par la LTr, appliquée sans condition.
