Clinical characteristics & outcome of SARS-CoV-2 infected neonates presenting to paediatric emergency.

Autor: Kumar J; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Kumar P; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Saini SS; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Sundaram V; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Mukhopadhyay K; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Dutta S; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Paulpandian RR; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Mittal P; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Das S; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Rameshbabu M; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Mandula PP; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Ranjan A; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Tiwari D; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Taneja M; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Garg A; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Jayashree M; Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Goyal K; Department of Virology, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Singh M; Department of Virology, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Puri GD; Department of Anaesthesia, Postgraduate Institute of Medical Education & Research, Chandigarh, India., M Lakshmi PV; Department of Hospital Administration, Postgraduate Institute of Medical Education & Research, Chandigarh, India., Guru RR; Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Jazyk: angličtina
Zdroj: The Indian journal of medical research [Indian J Med Res] 2022 Jan; Vol. 155 (1), pp. 189-196.
DOI: 10.4103/ijmr.IJMR_461_21
Abstrakt: Background & Objectives: Data on neonatal COVID-19 are limited to the immediate postnatal period, with a primary focus on vertical transmission in inborn infants. This study was aimed to assess the characteristics and outcome of COVID-19 in outborn neonates.
Methods: All neonates admitted to the paediatric emergency from August 1 to December 31, 2020, were included in the study. SARS-CoV-2 reverse transcription- (RT)-PCR test was done on oro/nasopharyngeal specimens obtained at admission. The clinical characteristics and outcomes of SARS-CoV-2 positive and negative neonates were compared and the diagnostic accuracy of a selective testing policy was assessed.
Results: A total of 1225 neonates were admitted during the study period, of whom SARS-CoV-2 RT-PCR was performed in 969. The RT-PCR test was positive in 17 (1.8%). Mean (standard deviation) gestation and birth weight of SARS-CoV-2-infected neonates were 35.5 (3.2) wk and 2274 (695) g, respectively. Most neonates (11/17) with confirmed COVID-19 reported in the first two weeks of life. Respiratory distress (14/17) was the predominant manifestation. Five (5/17, 29.4%) SARS-CoV-2 infected neonates died. Neonates with COVID-19 were at a higher risk for all-cause mortality [odds ratio (OR): 3.1; 95% confidence interval (CI): 1.1-8.9, P=0.03]; however, mortality did not differ after adjusting for lethal malformation (OR: 2.4; 95% CI: 0.7-8.7). Sensitivity, specificity, accuracy, positive and negative likelihood ratios (95% CI) of selective testing policy for SARS-CoV-2 infection at admission was 52.9 (28.5-76.1), 83.3 (80.7-85.6), 82.8 (80.3-85.1), 3.17 (1.98-5.07), and 0.56 (0.34-0.93) per cent, respectively.
Interpretation & Conclusions: SARS-CoV-2 positivity rate among the outborn neonates reporting to the paediatric emergency and tested for COVID-19 was observed to be low. The selective testing policy had poor diagnostic accuracy in distinguishing COVID-19 from non-COVID illness.
Databáze: MEDLINE
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