ABSTRACT
Background There are conflicting data on the mother-to-child transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and few studies have described the clinical course of neonates infected with SARS-CoV-2. Objectives This study investigates the mother-to-child transmission rate and clinical profile of SARS-CoV-2-infected newborns. Methods Data on 304 newborns of 301 mothers with coronavirus disease 2019 (COVID-19) were prospectively collected and analyzed. Reverse transcription-polymerase chain reaction (RT-PCR) determined the presence of SARS-CoV-2 in the placenta, umbilical cord stump, and nasopharyngeal swabs collected within 24h of birth. Clinical and laboratory data of SARS-CoV-2-infected newborns was entered in a structured proforma. Results A total of 20 neonates (6.5%) were positive for SARS-CoV-2, of which 12 were positive only in the nasopharyngeal swab, four cases had the umbilical stump positive, three were positive in the placenta, and one case was positive in all the three specimens collected. Six of the 20 SARS-CoV-2-positive neonates developed severe symptoms. The SARS-CoV-2-positive symptomatic neonates required a more extended stay in hospital compared to their non-symptomatic infected counterparts. Conclusions A proportion of the babies born to SARS-CoV2-infected mothers tested positive and some of these newborns had severe symptoms.
ABSTRACT
The aims and objectives of this study were to study clinical profile and factors affecting mortality in tetanus. This was a retrospective study of 25 tetanus patients (aged 6 months-12 years) admitted to pediatric intensive care unit of a tertiary center (over 3 years). In this study, 25 tetanus cases (mean age 6.6 years) were analyzed; 16 were males and 9 were females. Incubation period ranged from 2 to 30 days (mean 8.2 days), period of onset from 11 to 120 hours (mean 42.8 hours), and duration of spasms from 4 to 26 days (mean 14 days). The commonest portal of entry was posttrauma (52%), followed by otogenic (40%). Eighteen patients had moderate and 7 had severe tetanus. Fifteen were unimmunized and 10 were partially immunized. The commonest complaints were trismus and spasms (100%), hypertonia (72%), fever (60%), dysphagia (48%), and neck stiffness (44%). Eight patients required primary tracheostomy and 11 required primary endotracheal intubation. Complications encountered were pneumonia (58%), conjunctivitis (41%), gastrointestinal bleed (37.5%), urinary infection (33%), acute kidney injury (AKI) following rhabdomyolysis (33%), sepsis (29%), disseminated intravascular coagulation (DIC) (25%), bedsores (25%), and acute respiratory distress syndrome (ARDS) (20%). Oral diazepam was most commonly used, followed by midazolam, vecuronium, and magnesium sulfate. Mortality rate was 32% (five moderate and three severe cases died). Short period of onset (less than 48 hours), AKI following rhabdomyolysis, sepsis, DIC, ARDS, and inotrope need were significantly associated with higher mortality. It is concluded that the commonest portal of entry was posttrauma. None of the patients was completely immunized. Short period of onset, AKI, sepsis, DIC, ARDS, and inotrope need predicted a higher mortality.
