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Svetlana I Kolesnichenko,1,* Irina A Kadyrova,1 Alyona V Lavrinenko,1 Zhibek A Zhumadilova,1 Olga V Avdienko,1 Yelena V Vinogradskaya,2 Yevgeniy A Fominykh,3 Lyudmila G Panibratec,3 Lyudmila L Akhmaltdinova1,4,* 1Shared Resource Laboratory, Research Centre, Karaganda Medical University, Karaganda, Kazakhstan; 2Regional Clinical Hospital of Karaganda, Perinatal Center No. 1, Karaganda, Kazakhstan; 3Regional Clinical Hospital of Karaganda, Perinatal Center No. 2, Karaganda, Kazakhstan; 4National Scientific Cardiac Surgery Center, Nur-Sultan, Kazakhstan*These authors contributed equally to this workCorrespondence: Svetlana I Kolesnichenko, Shared Resource Laboratory, Research Centre, Karaganda Medical University, 40 Gogol St, Karaganda, 100008, Kazakhstan, Tel +7 702 599 0225, Email kolesnichenko@kgmu.kzPurpose: This study aimed to determine predisposing factors for negative outcome in infants with early neonatal sepsis during COVID-19.Patients and Methods: A prospective cohort study of 172 newborns up to 4 days diagnosed with neonatal sepsis was carried out in Karaganda (Kazakhstan). The microbiological examination was used to identify a causative agent of bloodstream infection. ELISA was performed to determine the total anti-SARS-CoV-2 antibodies. Gestational age, mode of delivery, birth weight, C-reactive protein and procalcitonin levels, comorbidities, type of pathogen, duration of hospitalization and mother’s infection diseases were used for statistical analysis.Results: Mortality in infants with neonatal sepsis was 22% (38/172). Anti-SARS-CoV-2 antibodies were detected in 68.3% of the newborns. Culture-negative ELBW infants have a 5.3-fold higher risk of death (p< 0.001). Low gestational age and a shorter period of hospitalization were statistically associated with fatality. CRP is generally higher in deceased children (p=0.002). Necrotizing enterocolitis (p< 0.001), pneumonia (p=0.009) and anemia (p=0.016) were significantly associated with negative outcome. And, 31.4% of the infants with sepsis had positive blood cultures. The leading cause of sepsis in newborns was CoNS – 57%.Conclusion: During COVID-19 pandemic neonatal sepsis mortality was associated with low birth weight, gestational age, and comorbidities as in non-pandemic time. The relationship between COVID-19 in the mother and neonatal mortality was not found. However, anti-SARS-CoV-2 antibodies were detected in more than half of newborns.Keywords: neonatal sepsis, preterm infants, mortality, coagulase-negative staphylococci, COVID-19 |
