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Wu YX, Wang DD, Zhao RQ, Jin OX, Yang JY, Zhang MX, Wang LZ. Differences in clinical characteristics of early-onset and late-onset severe acute respiratory syndrome coronavirus 2 infections in neonates. Eur J Pediatr 2024; 183:1741-1750. [PMID: 38233605 PMCID: PMC11001696 DOI: 10.1007/s00431-024-05433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/19/2024]
Abstract
Differences in clinical characteristics of early-onset and late-onset severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in neonates remain unclear. This study aimed to determine whether there are differences in the main clinical, radiological, and laboratory features of early-onset and late-onset SARS-CoV-2 infections in neonates. This single-center, prospective cohort study enrolled neonates with SARS-CoV-2 infection from December 7, 2022, to January 3, 2023, and evaluated their clinical characteristics during hospitalization. All neonates (N = 58) infected with SARS-CoV-2 within 28 days of birth who were admitted to the neonatal intensive care unit of Taizhou Hospital were included. These neonates were classified into the early-onset (diagnosed within 7 days of birth) and late-onset (diagnosed more than 7 days after birth) groups. The symptoms, treatment, and prognosis of SARS-CoV-2 infection were the main study outcomes. The incidence of hospitalization attributable to SARS-CoV-2 infection was 10.6% (58 of 546 neonates) in Linhai. Sixteen (28%) of the 58 SARS-CoV-2 infections were early-onset cases, and 42 (72%) were late-onset cases. The common symptoms among the late-onset group were fever (p < 0.001) and cough (p < 0.001). Neonates with late-onset SARS-CoV-2 infection (p < 0.001) were significantly more likely to develop pneumonia. Conclusion: The clinical symptoms and rates of pneumonia caused by SARS-CoV-2 infection in neonates differed between the early-onset and late-onset groups. Different clinical management is necessary for neonates with early-onset and late-onset SARS-CoV-2 infections. What is Known: • Neonates are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). • Differences in clinical characteristics of early-onset and late-onset SARS-CoV-2 infections in neonates remain unclear. What is New: • Fever and cough were the most common symptoms among neonates with late-onset infection. • Neonates with late-onset SARS-CoV-2 infection were more likely to develop pneumonia.
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Affiliation(s)
- Yi-Xin Wu
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang, China
| | - Dan-Dan Wang
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang, China
| | - Ru-Qi Zhao
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang, China
| | - Ou-Xuan Jin
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang, China
| | - Jing-Yun Yang
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang, China
| | - Mei-Xian Zhang
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang, China.
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang Province, China.
| | - Li-Zhen Wang
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang, China.
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