Early estimates of nirsevimab immunoprophylaxis effectiveness against hospital admission for respiratory syncytial virus lower respiratory tract infections in infants, Spain, October 2023 to January 2024.

The monoclonal antibody nirsevimab was at least 70% effective in preventing hospitalisations in infants with lower respiratory tract infections (LRTI) positive for respiratory syncytial virus (RSV) in Spain (Oct 2023-Jan 2024), where a universal immunisation programme began late September (coverage range: 79-99%). High protection was confirmed by two methodological designs (screening and test-negative) in a multicentre active surveillance in nine hospitals in three regions. No protection against RSV-negative LRTI-hospitalisations was shown. These interim results could guide public-health decision-making.

Variation in the seasonality of the respiratory syncytial virus during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has caused a variation in the circulation of common respiratory viruses. Our objective was to analyse the epidemiology of respiratory syncytial virus (RSV) bronchiolitis admissions during the COVID-19 pandemic in comparison with previous epidemic seasons. METHODS: We conducted an observational study involving infants with RSV bronchiolitis admitted to a tertiary hospital during two periods: pandemic COVID-19 (15 March 2020-30 September 2021) and pre-pandemic (1 October 2014-14 March 2020). Demographic and clinical characteristics were collected. RESULTS: A total of 270 patients were admitted for RSV bronchiolitis: 253 in the pre-pandemic period with an average of 42 admissions per season vs 17 in the pandemic. During the pandemic, the RSV outbreak started late in June 2021 with a higher percentage of prematurity and PICU admissions. CONCLUSION: A change in RSV seasonality was observed during the COVID-19 pandemic, with an unusual outbreak in summer 2021 of lower magnitude than previous seasons.

Tratamiento insulínico, requerimientos de insulina y resultados perinatales en una cohorte de embarazadas con diabetes tipo 1 / Insulin treatment, insulin requirements and perinatal outcomes in a pregnancy cohort with type 1 diabetes

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Neonatal Infection Due to SARS-CoV-2: An Epidemiological Study in Spain.

Objective: Coronavirus disease 2019 (COVID-19) cases caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to increase worldwide. Although some data from pediatric series are available, more evidence is required, especially in neonates, a group with specific characteristics that deserve special attention. This study aimed to describe general and clinical characteristics, management, and treatment of postnatal-acquired (community and nosocomial/hospital-acquired) COVID-19 neonatal cases in Spain. Methods: This was a national prospective epidemiological study that included cases from a National Registry supported by the Spanish Society of Neonatology. Neonates with postnatal SARS-CoV-2 infection were included in this study. General data and infection-related information (mode and source of transmission, age at diagnosis, clinical manifestations, need for hospitalization, admission unit, treatment administered, and complementary studies performed, hospital stay associated with the infection) were collected. Results: A total of 40 cases, 26 community-acquired and 14 nosocomial were registered. Ten were preterm newborns (2 community-acquired and 8 nosocomial COVID-19 cases). Mothers (in both groups) and healthcare workers (in nosocomial cases) were the main source of infection. Hospital admission was required in 22 community-acquired cases [18 admitted to the neonatal intermediate care unit (NIMCU) and 4 to the neonatal intensive care unit (NICU)]. Among nosocomial COVID-19 cases (n = 14), previously admitted for other reasons, 4 were admitted to the NIMCU and 10 to the NICU. Ten asymptomatic patients were registered (5 in each group). In the remaining cases, clinical manifestations were generally mild in both groups, including upper respiratory airways infection, febrile syndrome or acute gastroenteritis with good overall health. In both groups, most severe cases occurred in preterm neonates or neonates with concomitant pathologies. Most of the cases did not require respiratory support. Hydroxychloroquine was administered to 4 patients in the community-acquired group and to 2 patients in the nosocomial group. Follow-up after hospital discharge was performed in most patients. Conclusions: This is the largest series of COVID-19 neonatal cases in Spain published to date. Although clinical manifestations were generally mild, prevention, treatment, and management in this group are essential.

Corticoides antenatales e incidencia de distrés respiratorio del recién nacido en las cesáreas programadas del pretérmino tardío y término precoz / Antenatal corticosteroids and incidence of neonatal respiratory distress after elective caesarean section in late preterm and term neonates

Introducción: El nacimiento por cesárea programada de los recién nacidos pretérmino tardíos y a término precoces aumenta el riesgo de distrés respiratorio. La administración de corticoides antenatales en estos casos podría disminuir el distrés respiratorio y su gravedad. Objetivos: Determinar la repercusión del uso de corticoides antenatales en las cesáreas programadas en el distrés respiratorio del recién nacido de 35 a 38 + 6 semanas de edad gestacional (SEG). Pacientes y métodos: Estudio analítico retrospectivo en un hospital de tercer nivel, de las cesáreas de 35+0 a 38+6 SEG desde enero de 2013 hasta abril de 2017. Recogida de datos de las historias clínicas de las gestantes y recién nacidos tras la instauración de un nuevo protocolo de administración de una dosis de betametasona a las gestantes con cesáreas programadas de esta edad gestacional. Análisis en 2 subgrupos: recién nacidos pretérmino (RNPT) 35-36 SEG y a término (RNT) 37-38 SEG. Resultados: En este periodo se realizaron 208 cesáreas programadas. Se administraron corticoides en 97 casos (46,6%). El porcentaje de distrés fue mayor en el grupo de cesáreas programadas de RNPT comparado con los RNT (29 vs. 8,8%; p < 0,001) y entre los RNT fue mayor a menor edad gestacional. Entre las cesáreas programadas tratadas y no tratadas con corticoides no se encontraron diferencias significativas en cuanto al desarrollo de distrés respiratorio (RNPT 30 vs. 30%; p = 1; RNT 9,1 vs. 6.9%; p = 0,6). Conclusiones: En este estudio no se encontraron diferencias estadísticamente significativas a favor del beneficio de la administración de una dosis antenatal de betametasona en la disminución del distrés respiratorio del recién nacido en las cesáreas programadas de 35+0 a 38+6 SEG. El retraso en la indicación de cesáreas programadas, siempre que sea posible, podría contribuir a disminuir la incidencia de distrés respiratorio

Introduction: Birth by elective caesarean section in late preterm and early term newborn increases the risk of respiratory distress. Administration of antenatal corticosteroids in these cases could reduce the respiratory distress and its severity. Objectives: To determine the influence of antenatal corticosteroids use in elective caesarean sections in the respiratory distress of the newborn from 35+0 to 38+6 weeks of gestational age. Patients and methods: Retrospective analytical study of caesarean sections from 35+0 to 38+6 gestational age was conducted in a tertiary hospital from January 2013 to April 2017. Data were collected from medical records of pregnant women and newborns after an implementation of new protocol of betamethasone administration to these elective caesarean sections. Analysis was performed on 2 newborn subgroups: preterm newborn (PTN) 35-36 gestational age and term (TN) 37-38 weeks. Results: A total of 208 elective caesarean sections were performed in the study period. Corticosteroids were administered in 97 (46.6%) of cases. The percentage of respiratory distress was higher in the group of preterm newborn compared to term newborn (29% vs. 8.8%, P<.001) and in term newborn higher at a lower gestational age. Between treated with corticosteroids or not, no significant differences were found in the treated and non-treated in the development of respiratory distress (PTN 30 vs. 30%, TN 9.1 vs. 6.9%, P=.6). Conclusions: No statistically significant differences were found in this study in favour of the administration of an antenatal dose of betamethasone in the reduction of respiratory distress in the elective caesarean sections from 35+0 to 38+6 gestational age. The delay in the indication of elective caesarean sections, whenever possible, could help reduce the incidence of newborn respiratory distress

[Antenatal corticosteroids and incidence of neonatal respiratory distress after elective caesarean section in late preterm and term neonates]. / Corticoides antenatales e incidencia de distrés respiratorio del recién nacido en las cesáreas programadas del pretérmino tardío y término precoz.

INTRODUCTION: Birth by elective caesarean section in late preterm and early term newborn increases the risk of respiratory distress. Administration of antenatal corticosteroids in these cases could reduce the respiratory distress and its severity. OBJECTIVES: To determine the influence of antenatal corticosteroids use in elective caesarean sections in the respiratory distress of the newborn from 35+0 to 38+6 weeks of gestational age. PATIENTS AND METHODS: Retrospective analytical study of caesarean sections from 35+0 to 38+6 gestational age was conducted in a tertiary hospital from January 2013 to April 2017. Data were collected from medical records of pregnant women and newborns after an implementation of new protocol of betamethasone administration to these elective caesarean sections. Analysis was performed on 2newborn subgroups: preterm newborn (PTN) 35-36 gestational age and term (TN) 37-38 weeks. RESULTS: A total of 208 elective caesarean sections were performed in the study period. Corticosteroids were administered in 97 (46.6%) of cases. The percentage of respiratory distress was higher in the group of preterm newborn compared to term newborn (29% vs. 8.8%, P<.001) and in term newborn higher at a lower gestational age. Between treated with corticosteroids or not, no significant differences were found in the treated and non-treated in the development of respiratory distress (PTN 30 vs. 30%, TN 9.1 vs. 6.9%, P=.6). CONCLUSIONS: No statistically significant differences were found in this study in favour of the administration of an antenatal dose of betamethasone in the reduction of respiratory distress in the elective caesarean sections from 35+0 to 38+6 gestational age. The delay in the indication of elective caesarean sections, whenever possible, could help reduce the incidence of newborn respiratory distress.