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[Clinical characteristics of neonates infected with the Omicron variant of SARS-CoV-2: a multicenter cross-sectional survey]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:678-684. [PMID: 37529948 PMCID: PMC10414171 DOI: 10.7499/j.issn.1008-8830.2302049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/09/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES To investigate the clinical characteristics of neonates infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS A cross-sectional survey was conducted on 542 hospitalized neonates with confirmed coronavirus disease 2019 (COVID-19) in 27 hospitals in Shenzhen from December 7, 2022, to January 12, 2023 (during the Omicron variant epidemic period). The neonates were divided into two groups: asymptomatic infection and symptomatic infection. The clinical characteristics, results of laboratory examination, chest X-ray findings, and outcome were compared between the two groups. RESULTS Among the 542 neonates, there were 285 males and 257 females. Among them, 515 (95.0%) were full-term infants, and 27 (5.0%) were preterm infants. The asymptomatic infection group had 60 cases, and the symptomatic infection group had 482 cases. Among them, 336 cases (69.7%) were mild, 125 cases (25.9%) were moderate, 15 cases (3.1%) were severe, and 6 cases (1.2%) were critical. Fever was the most common symptom (434 cases, 90.0%), followed by cough and/or spitting (183 cases, 38.0%), nasal congestion and/or runny nose (131 cases, 27.2%), shortness of breath (36 cases, 7.5%), and feeding intolerance (30 cases, 6.2%). Among the 325 cases who underwent chest X-ray examination, 136 cases (41.8%) had patchy or consolidative shadows in the lungs, 2 cases (0.6%) had pneumothorax, 2 cases (0.6%) had decreased lung transparency, and 185 cases (57.0%) showed no abnormality. Among the 396 cases (73.1%) who received treatment, 341 cases (86.1%) received symptomatic treatment, 137 cases (34.6%) received antibiotic treatment, 4 cases (1.0%) received immunoglobulin treatment, and 23 cases (5.8%) received respiratory support treatment. All 542 neonates were discharged from the hospital after their clinical symptoms were relieved, and the median hospital stay was 5 days. The white blood cell count, neutrophil count, hemoglobin, and procalcitonin were lower in the symptomatic infection group than those in the asymptomatic infection group (P<0.05), while the platelet count and blood glucose levels were higher in the symptomatic infection group than those in the asymptomatic infection group (P<0.05). The proportions of neonates with decreased neutrophil count, increased platelet count, and decreased hemoglobin concentration were higher in the symptomatic infection group than those in the asymptomatic group (P<0.05). CONCLUSIONS Most neonates with COVID-19 caused by the Omicron variant of SARS-CoV-2 are mild, with fever as the predominant symptom. Symptomatic neonates with COVID-19 are often accompanied by decreased neutrophil count, increased platelet count, and decreased hemoglobin level. Symptomatic treatment is the main treatment, and the prognosis is good.
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[Perinatal and neonatal management plan for prevention and control of SARS-CoV-2 infection (3rd Edition)]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:1-4. [PMID: 36655656 PMCID: PMC9893817 DOI: 10.7499/j.issn.1008-8830.2212074] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Since the global pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2020, the virus has been evolving through mutations to acquire enhanced infectivity but reduced virulence. With a wide vaccination coverage among Chinese population, China is entering a new stage of SARS-CoV-2 infection control. The Working Group for the Prevention and Control of Neonatal SARS-CoV-2 Infection in the Perinatal Period of the Editorial Committee of Chinese Journal of Contemporary Pediatrics released the first and second editions of perinatal and neonatal management plan for prevention and control of SARS-CoV-2 infection in January and March 2020, respectively. In order to follow up new prevention and control needs, it is necessary to update the management plan to better guide clinical practice. Therefore, the Working Group formulated the 3rd-edition plan.
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Richter LL, Ho MSP, Zhang Q, Bone JN, Portales-Casamar E, Yang CL, Roberts A, Kang K, Kieran E, Lam C, Lisonkova S, Ting JY. Impact of Perinatal Exposure to SARS-CoV-2 Infection on Early Health Outcomes among Infants Born from 2020 to 2021 in British Columbia, Canada. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:9968774. [PMID: 37188258 PMCID: PMC10181900 DOI: 10.1155/2023/9968774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/10/2023] [Accepted: 03/15/2023] [Indexed: 05/17/2023]
Abstract
Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has impacted healthcare services and outcomes. We aimed to investigate healthcare resource utilization and early health outcomes of infants born to mothers with perinatal SARS-CoV-2 infection. Methods The study included all infants born alive between February 1, 2020, and April 30, 2021, in British Columbia. We used linked provincial population-based databases including data on COVID-19 testing, birth, and health information for up to one year from birth. Perinatal COVID-19 exposure for infants was defined being born to mothers with a positive test for SARS-CoV-2 infection during pregnancy or at delivery. Cases of COVID-19-exposed infants were matched with up to four non-exposed infants by birth month, sex, birthplace, and gestational age in weeks. Outcomes included hospitalizations, emergency department visits, and in-/outpatient diagnoses. Outcomes were compared between groups using conditional logistic regression and linear mixed effects models including effect modification by maternal residence. Results Among 52,711 live births, 484 infants had perinatal exposure to SARS-CoV-2, an incidence rate of 9.18 per 1000 live births. Exposed infants (54.6% male) had a mean gestational age of 38.5 weeks, and 99% were born in hospital. Proportions of infants requiring at least one hospitalization (8.1% vs. 5.1%) and at least one emergency department visit (16.9% vs. 12.9%) were higher among the exposed vs. unexposed infants, respectively. Among infants from the urban area, those with exposure were more likely to have respiratory infectious diseases (odds ratio: 1.74; 95% confidence intervals: 1.07, 2.84), compared with those without exposure. Interpretation. In our cohort, infants born to mothers with SARS-CoV-2 infection have increased healthcare demands in their early infancy, which warrants further investigation.
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Affiliation(s)
- Lindsay L. Richter
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Matthew S. P. Ho
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Qian Zhang
- Research Informatics, BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Jeffrey N. Bone
- Research Informatics, BC Children's Hospital Research Institute, Vancouver, BC, Canada
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Elodie Portales-Casamar
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
- Research Informatics, BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Connie L. Yang
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Ashley Roberts
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Kristopher Kang
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Emily Kieran
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Carol Lam
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Sarka Lisonkova
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Joseph Y. Ting
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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de Moraes FM, de Souza JWPS, Alves LP, de Siqueira MFR, dos Santos APA, de Carvalho Berardo MM, Granja MG, de Castro-Faria-Neto HC. SARS-CoV-2 Infection and Possible Neonatal Neurological Outcomes: A Literature Review. Viruses 2022; 14:1037. [PMID: 35632778 PMCID: PMC9143946 DOI: 10.3390/v14051037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 11/16/2022] Open
Abstract
The virus responsible for COVID-19 is designated "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2), a highly transmissible and pathogenic coronavirus. Although people of all ages are susceptible to SARS-CoV-2 infection, clinical manifestations may vary with age. The response of neonates to SARS-CoV-2 infection or exposure differs from that of children and adults. Encephalitis due to viral infections in the central nervous system (CNS) and childhood multisystem inflammatory syndrome (MIS-C) are some of the possible neonatal consequences of SARS-CoV-2 infection. This review aims to verify possible neonatal neurological outcomes after SARS-CoV-2 infection. Overall, the cellular and molecular basis of the neurological sequelae of SARS-CoV-2 in neonates remains unclear, and attempts to elucidate the pathophysiology of COVID-19 involve a comparison with the mechanism of other viral diseases. There are a considerable number of case reports in the literature exploring neurological outcomes in the neonatal period. In this review, we present possible effects of SARS-CoV-2 in neonates, emphasizing the importance of monitoring this group. The mechanisms of SARS-CoV-2 entry into the CNS have not yet been fully elucidated, and the potential severity of SARS-CoV-2 infection in neonates, as well as the possible short- and long-term neurological sequelae, remain unclear.
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Affiliation(s)
- Flávia Maciel de Moraes
- Programa de Pós-Graduação em Biologia Molecular e Celular, Universidade Federal do Estado do Rio de Janeiro—UNIRIO, Rua Frei Caneca, 94-Centro, Rio de Janeiro 20211-010, Brazil; (F.M.d.M.); (L.P.A.)
| | - Julia Werneck Paulino Soares de Souza
- Instituto de Educação Médica—IDOMED, Escola de Medicina, Universidade Estácio de Sá, Avenida Presidente Vargas, 1121-Centro, Rio de Janeiro 20071-004, Brazil; (J.W.P.S.d.S.); (M.M.d.C.B.)
| | - Letícia Pires Alves
- Programa de Pós-Graduação em Biologia Molecular e Celular, Universidade Federal do Estado do Rio de Janeiro—UNIRIO, Rua Frei Caneca, 94-Centro, Rio de Janeiro 20211-010, Brazil; (F.M.d.M.); (L.P.A.)
| | - Milena Ferreira Ribeiro de Siqueira
- Faculdade de Biomedicina, Instituto Biomédico, Universidade Federal Fluminense, Rua Ernani Melo, 101-São Domingos, Niterói 24210-130, Brazil;
| | - Ana Paula Aguiar dos Santos
- Escola de Medicina, Fundação Técnico-Educacional Souza Marques, Avenida Ernani Cardoso, 335-Cascadura, Rio de Janeiro 20020-080, Brazil;
| | - Mariana Monteiro de Carvalho Berardo
- Instituto de Educação Médica—IDOMED, Escola de Medicina, Universidade Estácio de Sá, Avenida Presidente Vargas, 1121-Centro, Rio de Janeiro 20071-004, Brazil; (J.W.P.S.d.S.); (M.M.d.C.B.)
| | - Marcelo Gomes Granja
- Laboratório de Imunofarmacologia, Fundação Oswaldo Cruz-Fiocruz, Avenida Brasil, 4365-Manguinhos, Rio de Janeiro 21045-900, Brazil;
| | - Hugo Caire de Castro-Faria-Neto
- Laboratório de Imunofarmacologia, Fundação Oswaldo Cruz-Fiocruz, Avenida Brasil, 4365-Manguinhos, Rio de Janeiro 21045-900, Brazil;
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