TY - JOUR
AU - Saha, Senjuti
AU - Ahmed, Nawshad Uddin
AU - Sarkar, Probir Kumar
AU - Bipul, Mohammed Rizwanul Ahsan
AU - Ghosh, Kinkar
AU - Rahman, Sheikh Wasik
AU - Rahman, Hafizur
AU - Hooda, Yogesh
AU - Ahsan, Nafiz
AU - Malaker, Roly
AU - Sajib, Mohammad Saiful Islam
AU - Islam, Mohammad Shahidul
AU - Anik, Ataul Mustufa
AU - Saha, Sudipta
AU - Kanon, Naito
AU - Islam, Islam
AU - Hamer, Davidson H.
AU - Amin, Ruhul
AU - Shahidullah, Mohammod
AU - Saha, Samir K.
PY - 2020
DA - December
TI - The direct and indirect impact of SARS-CoV-2 infections on neonates: a series of 26 cases in Bangladesh
JO - Pediatric Infectious Disease Journal
EP - e405
VL - 39
IS - 12
DO - https://doi.org/10.1097/INF.0000000000002921
AB - 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.
PB - Wolters Kluwer
UR - http://eprints.gla.ac.uk/244788/
KW - Coronavirus (COVID-19)
KW - Maternity and early years
ER