The OPEN minute newsletter / COVID-19 in Neonates and Infants
January 12, 2023

COVID-19 in Neonates and Infants

Coronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although children seem to have less severe clinical symptoms of the disease, the potential harm of this disease remains largely unknown, especially in neonates. The data suggest that severe illness is more common in neonates and infants than in older children.

According to the CDC’s latest publications, the incubation period of SARS-CoV-2 is about the same for children as in adults, at 2-14 days with an average of 6 days. Signs or symptoms of COVID-19 in children include fever, fatigue, myalgia, cough, nasal congestion or rhinorrhea, poor appetite or feeding, shortness of breath, or difficulty breathing.

There were more than 200 neonates and infants with positive Covid19 PCR tests hospitalized in our clinic during the 2020-2021 years. The most frequent symptoms were fever, cough, dyspnea, catarrhal signs, vomiting, loss of appetite, and weakness. 74.2% were diagnosed with nasopharyngitis, 13.6 % had bronchiolitis, 10.6% had pneumonia, and 1.5% had enterocolitis. Although most of the hospitalized cases were mild or moderate, there were 3 cases of ischemic stroke among neonates, 2 cases of severe thrombocytopenia, and a few cases of reactive thrombocytosis.

Data from our clinic about the clinical characteristics of Covid19 among neonates and infants is identical to the international data, and the mortality rate is very low in this age group.

Despite intense research, it remains unclear why neonates mainly experience mild symptoms and have lower mortality rates. The presence of a few severe cases identifies the necessity of further follow-up of this age group of Covid-19 infected patients.

 

Hope this helps!

 

Best regards,

Anahit Grigoryan, Pediatric department N1, Muratsan University Hospital

References and Resources
  • National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases. Information for pediatric healthcare providers. Centers for Disease Control and Prevention. October 19, 2022. Accessed December 28, 2022. https://www.cdc.gov/coronavirus/2019-ncov/hcp/pediatric-hcp.html
  • Children and COVID-19: state-level data report. American Academy of Pediatrics (AAP). Updated December 22, 2022. Accessed December 28, 2022. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/
  • Hoang A, Chorath K, Moreira A, et al. COVID-19 in 7780 pediatric patients: A systematic review. EClinicalMedicine. 2020;24:100433. Published 2020 Jun 26. doi:10.1016/j.eclinm.2020.100433
  • Bellino S, Punzo O, Rota MC, et al. COVID-19 Disease Severity Risk Factors for Pediatric Patients in Italy. Pediatrics. 2020;146(4):e2020009399. doi:10.1542/peds.2020-009399
  • Kitano T, Kitano M, Krueger C, et al. The differential impact of pediatric COVID-19 between high-income countries and low- and middle-income countries: A systematic review of fatality and ICU admission in children worldwide. PLoS One. 2021;16(1):e0246326. Published 2021 Jan 29. doi:10.1371/journal.pone.0246326
  • Image Source: “A new born baby” by rawpixel.com is licensed under Freepik License.
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