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Title: | Epidemiologic and clinical characteristics of neonates with late-onset COVID-19: 1-year data of Turkish Neonatal Society | Authors: | Akin I.M. Kanburoglu M.K. Tayman C. Oncel M.Y. Imdadoglu T. Dilek M. Yaman A. Narter, Fatma Er, Ilkay Kahveci, Hasan Erdeve, Omer Koc, Esin Yildiz, Eren Melekoglu, Nuriye Aslı Okulu, Emel Toptan, Handan Hakyemez Surmeli, Ozge Can, Emrah Yilmaz, Fatma Hilal Ozkan, Hilal Caner, Ibrahim Cömert, Serdar Uygun, Saime Sundus Akbay, Sinem Memisoglu, Asli Anik, Ayse Arcagok, Baran Cengiz Karagol, Belma Saygili Ates, Mehmet Bulut, Muhammet Akin, Mustafa Ali Demir, Nihat Ozdemir, Ramazan Arayici, Sema Kader, Sebnem Zubarioglu, Adil Umut Oktem, Ahmet Bulbul, Ali Hekimoglu, Berna Ataoglu, Emel Baser, Demet Orhan Yalinbas, Emine Esin Imamoglu, Ebru Yalin Ozlu, Ferda Bilgin, Leyla Kefeli, Melike Arslan, Meltem Koyuncu Akar, Selahattin Bezirganoglu, Handan Bozdag, Senol Gurpinar, Resat Ciftdemir, Nukhet Aladag Ozdemir, Ozmert Ma |
Keywords: | COVID-19 Newborn Postnatal SARS-CoV-2 ampicillin azithromycin C reactive protein carbapenem derivative cephalosporin derivative gentamicin oseltamivir vancomycin Article artificial milk artificial ventilation assisted ventilation birth weight breast feeding clinical feature cohort analysis computer assisted tomography continuous positive airway pressure controlled study coronavirus disease 2019 coughing COVID-19 testing diarrhea disseminated intravascular clotting epidemiological data female fever follow up ground glass opacity hospitalization human irritability lung consolidation major clinical study male mother to child transmission multiple organ failure myocarditis neonatal intensive care unit newborn newborn infection oxygen therapy partial thromboplastin time prospective study protein expression prothrombin time rash real time polymerase chain reaction rhinorrhea Severe acute respiratory syndrome coronavirus 2 somnolence tachypnea coughing epidemiology infant myocarditis pregnancy pregnancy complication vertical transmission Cough COVID-19 Female Humans Infant Infant, Newborn Infectious Disease Transmission, Vertical Myocarditis Pregnancy Pregnancy Complications, Infectious Prospective Studies SARS-CoV-2 Tachypnea |
Publisher: | Springer Science and Business Media Deutschland GmbH | Abstract: | The literature on neonates with SARS-CoV-2 is mainly concerned with perinatal cases, and scanty data are available about environmentally infected neonates. To fill knowledge gaps on the course and prognosis of neonatal cases, we analyzed 1-year data from the Turkish Neonatal Society in this prospective cohort study of neonates with postnatal transmission. Data from 44 neonatal intensive care units (NICUs), of neonates with positive RT-PCR results at days 5–28 of life, were extracted from the online registry system and analyzed. Of 176 cases, most were term infants with normal birth weight. Fever was the most common symptom (64.2%), followed by feeding intolerance (25.6%), and cough (21.6%). The median length of hospitalization was 9 days, with approximately one quarter of infants receiving some type of ventilatory support. Myocarditis (5.7%) was the most common complication during follow-up. Among the clinical findings, cough (odds ratio [OR]: 9.52, 95% confidence interval [CI]: 4.17–21.71), tachypnea (OR: 26.5, 95% CI: 9.59–73.19), and chest retractions (OR: 27.5, 95% CI: 5.96–126.96) were associated with more severe clinical disease. Also, there were significant differences in the C-reactive protein level, prothrombin time (PT), partial thromboplastin time, international normalized ratio, and days in the NICU (p = 0.002, p = 0.012, p = 0.034, p = 0.008, and p < 0.001, respectively) between patients with mild-moderate and severe-critical presentations. A PT above 14 s was a significant predictor of severe/critical cases, with a sensitivity of 64% and specificity of 73%. Conclusions: Our data showed that late-onset COVID-19 infection in neonates who need hospitalization can be severe, showing associations with high rates of ventilatory support and myocarditis. Cough, tachypnea, and retractions on admission suggest a severe disease course. Trial registration: ClinicalTrials.gov identifier: NCT04401540.What is Known:• Neonatal cases of COVID-19 infection are mainly reported as perinatal COVID-19 cases.• Neonates with perinatal transmission have a mild course and favorable prognosis.What is New:• Among symptomatic neonates with late-onset COVID-19 infection, fever was the most common symptom, and almost one quarter of hospitalized cases needed some type of respiratory support. Myocarditis was the most common complication.• The presence of cough, tachypnea, retractions, and a PT above 14 s were associated with an increased risk of severe COVID-19. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. | URI: | https://doi.org/10.1007/s00431-021-04358-8 https://hdl.handle.net/11499/47356 |
ISSN: | 0340-6199 |
Appears in Collections: | PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection Tıp Fakültesi Koleksiyonu WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
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