1
|
Akin IM, Kanburoglu MK, Tayman C, Oncel MY, Imdadoglu T, Dilek M, Yaman A, Narter F, Er I, Kahveci H, Erdeve O, Koc E. Epidemiologic and clinical characteristics of neonates with late-onset COVID-19: 1-year data of Turkish Neonatal Society. Eur J Pediatr 2022; 181:1933-1942. [PMID: 35061093 PMCID: PMC8776552 DOI: 10.1007/s00431-021-04358-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/16/2021] [Accepted: 12/19/2021] [Indexed: 12/24/2022]
Abstract
The literature on neonates with SARS-CoV-2 is mainly concerned with perinatal cases, and scanty data are available about environmentally infected neonates. To fill knowledge gaps on the course and prognosis of neonatal cases, we analyzed 1-year data from the Turkish Neonatal Society in this prospective cohort study of neonates with postnatal transmission. Data from 44 neonatal intensive care units (NICUs), of neonates with positive RT-PCR results at days 5-28 of life, were extracted from the online registry system and analyzed. Of 176 cases, most were term infants with normal birth weight. Fever was the most common symptom (64.2%), followed by feeding intolerance (25.6%), and cough (21.6%). The median length of hospitalization was 9 days, with approximately one quarter of infants receiving some type of ventilatory support. Myocarditis (5.7%) was the most common complication during follow-up. Among the clinical findings, cough (odds ratio [OR]: 9.52, 95% confidence interval [CI]: 4.17-21.71), tachypnea (OR: 26.5, 95% CI: 9.59-73.19), and chest retractions (OR: 27.5, 95% CI: 5.96-126.96) were associated with more severe clinical disease. Also, there were significant differences in the C-reactive protein level, prothrombin time (PT), partial thromboplastin time, international normalized ratio, and days in the NICU (p = 0.002, p = 0.012, p = 0.034, p = 0.008, and p < 0.001, respectively) between patients with mild-moderate and severe-critical presentations. A PT above 14 s was a significant predictor of severe/critical cases, with a sensitivity of 64% and specificity of 73%. CONCLUSIONS Our data showed that late-onset COVID-19 infection in neonates who need hospitalization can be severe, showing associations with high rates of ventilatory support and myocarditis. Cough, tachypnea, and retractions on admission suggest a severe disease course. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04401540. WHAT IS KNOWN • Neonatal cases of COVID-19 infection are mainly reported as perinatal COVID-19 cases. • Neonates with perinatal transmission have a mild course and favorable prognosis. WHAT IS NEW • Among symptomatic neonates with late-onset COVID-19 infection, fever was the most common symptom, and almost one quarter of hospitalized cases needed some type of respiratory support. Myocarditis was the most common complication. • The presence of cough, tachypnea, retractions, and a PT above 14 s were associated with an increased risk of severe COVID-19.
Collapse
Affiliation(s)
- Ilke Mungan Akin
- Division of Neonatology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mehmet Kenan Kanburoglu
- Division of Neonatology, Department of Pediatrics, School of Medicine, Rize Recep Tayyip Erdogan University, Rize, Turkey
| | - Cuneyt Tayman
- Division of Neonatology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Mehmet Yekta Oncel
- Division of Neonatology, Department of Pediatrics, School of Medicine, İzmir Katip Celebi University, Izmir, Turkey
- Division of Neonatology, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Timucin Imdadoglu
- Division of Neonatology, Sancaktepe Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mustafa Dilek
- Division of Neonatology, Department of Pediatrics, School of Medicine, Abant Izzet Baysal University, Bolu, Turkey
| | - Akan Yaman
- Division of Neonatology, Department of Pediatrics, School of Medicine, Nisantasi University, Istanbul, Turkey
| | - Fatma Narter
- Division of Neonatology, Ministry of Health Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Ilkay Er
- Division of Neonatology, Kocaeli Derince Training and Research Hospital, University of Health Sciences, Kocaeli, Turkey
| | - Hasan Kahveci
- Division of Neonatology, Department of Pediatrics, Erzurum Bolge Hastanesi, University of Health Sciences, Erzurum, Turkey
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, School of Medicine, Ankara University, Ankara, Turkey
| | - Esin Koc
- Division of Neonatology, Department of Pediatrics, School of Medicine, Gazi University, Ankara, Turkey
| |
Collapse
|
2
|
Porpora MG, Merlino L, Masciullo L, D’Alisa R, Brandolino G, Galli C, De Luca C, Pecorini F, Fonsi GB, Mingoli A, Franchi C, Oliva A, Manganaro L, Mastroianni CM, Piccioni MG. Does Lung Ultrasound Have a Role in the Clinical Management of Pregnant Women with SARS COV2 Infection? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052762. [PMID: 33803223 PMCID: PMC7967479 DOI: 10.3390/ijerph18052762] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 02/07/2023]
Abstract
Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection is a major health threat. Pregnancy can lead to an increased susceptibility to viral infections. Although chest computed tomography (CT) represents the gold standard for the diagnosis of SARS-CoV-2 pneumonia, lung ultrasound (LUS) could be a valid alternative in pregnancy. The objectives of this prospective study were to assess the role of LUS in the diagnosis of lung involvement and in helping the physicians in the management of affected patients. Thirty pregnant women with SARS-CoV-2 infection were admitted at the obstetrical ward of our Hospital. Mean age was 31.2 years, mean gestational age 33.8 weeks. Several LUS were performed during hospitalization. The management of the patients was decided according to the LUS score and the clinical conditions. Mean gestational age at delivery was at 37.7 weeks, preterm birth was induced in 20% of cases for a worsening of the clinical conditions. No neonatal complications occurred. In 9 cases with a high LUS score, a chest CT was performed after delivery. CT confirmed the results of LUS, showing a significant positive correlation between the two techniques. LUS seems a safe alternative to CT in pregnancy and may help in the management of these patients.
Collapse
Affiliation(s)
- Maria Grazia Porpora
- Department of Maternal and Child Health and Urological Sciences, Sapienza, University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy; (M.G.P.); (L.M.); (L.M.); (R.D.); (G.B.); (C.D.L.); (F.P.); (M.G.P.)
| | - Lucia Merlino
- Department of Maternal and Child Health and Urological Sciences, Sapienza, University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy; (M.G.P.); (L.M.); (L.M.); (R.D.); (G.B.); (C.D.L.); (F.P.); (M.G.P.)
| | - Luisa Masciullo
- Department of Maternal and Child Health and Urological Sciences, Sapienza, University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy; (M.G.P.); (L.M.); (L.M.); (R.D.); (G.B.); (C.D.L.); (F.P.); (M.G.P.)
| | - Rossella D’Alisa
- Department of Maternal and Child Health and Urological Sciences, Sapienza, University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy; (M.G.P.); (L.M.); (L.M.); (R.D.); (G.B.); (C.D.L.); (F.P.); (M.G.P.)
| | - Gabriella Brandolino
- Department of Maternal and Child Health and Urological Sciences, Sapienza, University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy; (M.G.P.); (L.M.); (L.M.); (R.D.); (G.B.); (C.D.L.); (F.P.); (M.G.P.)
| | - Cecilia Galli
- Department of Maternal and Child Health and Urological Sciences, Sapienza, University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy; (M.G.P.); (L.M.); (L.M.); (R.D.); (G.B.); (C.D.L.); (F.P.); (M.G.P.)
- Correspondence:
| | - Casimiro De Luca
- Department of Maternal and Child Health and Urological Sciences, Sapienza, University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy; (M.G.P.); (L.M.); (L.M.); (R.D.); (G.B.); (C.D.L.); (F.P.); (M.G.P.)
| | - Francesco Pecorini
- Department of Maternal and Child Health and Urological Sciences, Sapienza, University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy; (M.G.P.); (L.M.); (L.M.); (R.D.); (G.B.); (C.D.L.); (F.P.); (M.G.P.)
| | - Giovanni Battista Fonsi
- Department of Surgery, “Pietro Valdoni”, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy; (G.B.F.); (A.M.)
| | - Andrea Mingoli
- Department of Surgery, “Pietro Valdoni”, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy; (G.B.F.); (A.M.)
| | - Cristiana Franchi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy; (C.F.); (A.O.); (C.M.M.)
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy; (C.F.); (A.O.); (C.M.M.)
| | - Lucia Manganaro
- Department of Radiological, Oncological, and Pathological Sciences, Sapienza, University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy;
| | - Claudio Maria Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy; (C.F.); (A.O.); (C.M.M.)
| | - Maria Grazia Piccioni
- Department of Maternal and Child Health and Urological Sciences, Sapienza, University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy; (M.G.P.); (L.M.); (L.M.); (R.D.); (G.B.); (C.D.L.); (F.P.); (M.G.P.)
| |
Collapse
|
3
|
Kumar J, Meena J, Yadav A, Kumar P. SARS-CoV-2 detection in human milk: a systematic review. J Matern Fetal Neonatal Med 2021; 35:5456-5463. [PMID: 33550866 DOI: 10.1080/14767058.2021.1882984] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE To synthesize the current evidence for the presence of SARS-CoV-2 RNA in the human milk of mothers with confirmed COVID-19 and its potential role in neonatal SARS-CoV-2 infection. MATERIALS AND METHODS Using terms related to novel coronavirus 2019 and human milk, a systematic search was performed in three electronic databases (PubMed, EMBASE, and Web of Science) for studies published between December 2019 and 15 October 2020. Published peer-reviewed studies reporting the results of RT-PCR for SARS-CoV-2 RNA in human milk in mothers with confirmed COVID-19 were included. Proportion meta-analysis of case series and prospective cohort studies was performed using STATA version 14.2 (StataCorp, College Station, TX) and pooled estimate (with 95% confidence interval) of overall incidence of SARS-CoV-2 transmission was calculated. RESULTS We identified 936 records, of which 34 studies (24 case-reports, 10 cohort studies) were eligible for this systematic review. A total of 116 confirmed COVID-19 lactating women (88 in cohort and 28 in case-reports) underwent RT-PCR testing in human milk, and 10 (six in case reports) were detected to have SARS-CoV-2 RNA. The overall pooled proportion (from cohort studies) for SARS-CoV-2 RNA detection in human milk was 2.16% (95% CI: 0.0-8.81%, I 2: 0%). Four studies (six patients) also reported the presence of SARS-CoV-2 specific antibodies (along with RT-PCR) in human milk. CONCLUSIONS The limited low-quality evidence suggests that SARS-CoV-2 RNA is detected in human milk in an extremely low proportion, however, based on current evidence no conclusion can be drawn about its infectivity and impact on the infants. In concordance with World Health Organization recommendations, exclusive breastfeeding should be considered in all cases unless any other contraindication exists.
Collapse
Affiliation(s)
- Jogender Kumar
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jitendra Meena
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Arushi Yadav
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
| | - Praveen Kumar
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
4
|
Erdeve Ö, Çetinkaya M, Baş AY, Narlı N, Duman N, Vural M, Koç E. Authors' Response. TURK PEDIATRI ARSIVI 2020; 55:458-459. [PMID: 33414671 PMCID: PMC7750335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 10/13/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Ömer Erdeve
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Merih Çetinkaya
- Division of Neonatology, Department of Pediatrics, University of Health Science Faculty of Medicine, İstanbul, Turkey
| | - Ahmet Yağmur Baş
- Division of Neonatology, Department of Pediatrics, Yıldırım Beyazit University Faculty of Medicine, Ankara, Turkey
| | - Nejat Narlı
- Division of Neonatology, Department of Pediatrics, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Nuray Duman
- Division of Neonatology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Mehmet Vural
- Division of Neonatology, Department of Pediatrics, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Esin Koç
- Division of Neonatology, Department of Pediatrics, Gazi University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|