Clinical Characteristics of COVID-۱۹ in Neonates and Infants Younger Than ۳ Months

Background: COVID-۱۹ is a respiratory infection that appeared as a pandemic affecting children and adults in China in ۲۰۱۹.  Objectives: To better understand COVID-۱۹ in young children, we evaluated the epidemiological, clinical, and outcomes of SARS-CoV-۲ infection in neonates and ۱-۳ months old infants and compared the differences between the two groups. Methods: This retrospective analysis included children with a COVID-۱۹ diagnosis admitted to Bouali and Imam Khomeini tertiary hospitals in Sari City, Iran, between March ۲۰۱۹ and March ۲۰۲۲. Demographic data such as age, sex, comorbidity, clinical characteristics and symptoms, medications, and laboratory test results were extracted from the patient’s medical records. Statistical analysis was performed using SPSS software, version ۲۲, and P<۰.۰۵ were considered statistically significant. Results: This study evaluated ۱۵۲ children, including ۳۴ neonates (۲۲.۴%) and ۱۱۸ infants (۷۷.۶%), with a median age of ۴۹.۵ [interquartile range (IQR): ۳۳-۶۶] days. The frequencies of mild, moderate, and severe/multisystem inflammatory system in children (MIS-C) cases were ۹۶(۶۳.۲%), ۲۹(۱۹.۱%), and ۲۷(۱۷.۸%), respectively (P=۰.۸۷۹). Overall, ۹۰ patients (۵۹.۲%) were boys, and ۶۲(۴۰.۸%) were girls (P=۰.۶۹۵). COVID-۱۹ reverse transcription-polymerase chain reaction (RT-PCR) test was positive in ۶۵ children (۴۲.۸%) (P=۰.۰۲۲), and ۳ (۲%) expired. Fever was the most common symptom (۷۵%), followed by cough (۵۶.۶%), poor feeding (۴۶.۱%), dyspnea (۳۲.۹%), and lethargy (۳۲.۲%). Twenty-nine patients (۱۹.۱%) required intensive care unit (ICU) admission, and ۶(۳.۹%) underwent mechanical ventilation (P=۰.۴۶۳ and P=۰.۱۲۶, respectively). The median duration of hospital stay was ۵ days (IQR: ۴-۷ days). The median duration of antibiotic therapy did not differ among the groups (P=۰.۷۸۶). Sepsis workup was performed in ۸۲.۹% of patients, and none had a positive cerebrospinal fluid culture. Conclusions: Although this study showed a ۵% vertical transmission rate, only delivery from a mother with COVID-۱۹ or having a positive COVID-۱۹ reverse transcription polymerase chain reaction (RT-PCR) test result without symptoms is not a reason for a sepsis workup. Moreover, in infants under ۳ months who are hospitalized due to confirmed COVID-۱۹ and do not have sepsis symptoms, there is no indication of a lumbar puncture (LP) procedure.

کلیدواژه ها:

Characteristic ، COVID-۱۹ ، Multisystem inflammatory system in children (MIS-C) ، Neonate ، Infant