The direct and indirect impact of SARS-CoV-2 infections on neonates: a series of 26 cases in Bangladesh

Saha, S. et al. (2020) The direct and indirect impact of SARS-CoV-2 infections on neonates: a series of 26 cases in Bangladesh. Pediatric Infectious Disease Journal, 39(12), e398-e405. (doi: 10.1097/inf.0000000000002921) (PMID:33031143) (PMCID:PMC7654949)

Abstract

Background: The impact of SARS-CoV-2 on neonates remains largely unknown in low- and middle-income countries (LMICs). We provide an epidemiologic and clinical report of SARS-CoV-2 infections in neonates hospitalized in Bangladesh. Methods: Outborn neonates admitted to Dhaka Shishu Hospital, a tertiary-care referral hospital, between 29 March and 1 July were screened for SARS-CoV-2. We reviewed clinical data, including chest radiograph and laboratory reports, and conducted SARS-CoV-2 genome sequencing. Patients were followed-up for 27–75 days. A subset of caregivers was also tested. Results: Of 83 neonates tested, 26 were positive (median age 8 days). Most neonates were admitted with diagnosis unrelated to SARS-CoV-2: 11 presented with serious non-communicable diseases, 7 with early-onset sepsis, 5 with late-onset sepsis and 2 with pneumonia. In 3 of 5 chest radiograph, infiltrates and ground-glass or patchy opacities were noted. Two neonates developed metabolic acidosis, one developed disseminated intravascular coagulation. Most SARS-CoV-2 positive neonates were referred to government-designated COVID-19 hospitals, leading to gaps in treatment. Twenty-three neonates could be followed-up: 12 were healthy, 8 died and 3 were still seeking medical care. Of 9 caregivers tested, 8 were positive. Conclusions: SARS-CoV-2 may have serious adverse effects on children born in LMICs. The virus likely contributed directly to two deaths, but the remaining 6 neonates who died had serious comorbidities. Positive SARS-CoV-2 test results led to gaps in immediate clinical care for other morbidities, which likely contributed to adverse outcomes. This case series emphasizes the need to understand COVID-19 in neonates in LMICs and its indirect impacts.

• Item Type: Articles
• Additional Information: This study was funded by the Bill and Melinda Gates Foundation (grants INV016932, OPP1198769).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Sajib, Mohammad Saiful Islam
• Authors: Saha, S., Ahmed, N. U., Sarkar, P. K., Bipul, M. R. A., Ghosh, K., Rahman, S. W., Rahman, H., Hooda, Y., Ahsan, N., Malaker, R., Sajib, M. S. I., Islam, M. S., Anik, A. M., Saha, S., Kanon, N., Islam, I., Hamer, D. H., Amin, R., Shahidullah, M., and Saha, S. K.
• College/School: College of Medical Veterinary and Life Sciences
• Journal Name: Pediatric Infectious Disease Journal
• Publisher: Lippincott, Williams & Wilkins
• ISSN: 0891-3668
• ISSN (Online): 0891-3668
• Copyright Holders: Copyright © 2020 The Author(s)
• First Published: First published in Pediatric Infectious Disease Journal 39(12):e398-e405
• Publisher Policy: Reproduced under a Creative Commons Licence