Published: 2021-06-24

Symptomatic neonatal SARS-CoV-2 infection in a tertiary care teaching hospital: an observational prospective study

Deepali A. Ambike, Sandhya V. Haribhakta, Suryakant Mundlod, Seema P. Soni, Rijwana Sayyad, Komal Bijraniya


Background: The likelihood of newborns acquiring severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) from infected mothers has raised concerns among families and clinicians worldwide. The disease seems to be mild in children and, to date; there are few reports in neonatal population. The aim of the study was to study the Prevalence of Neonatal SARS-CoV-2 infection in a tertiary care teaching hospital. The objective of the study was to study correlation of clinical features and laboratory parameters among SARS-CoV-2 positive neonates.

Methods: Prospective observational study conducted in a dedicated COVID-19 tertiary care hospital and Postgraduate Institute in Pune, Maharashtra between May 2020 and August 2020 on a sample size of 55 COVID suspect neonates as they were admitted and diagnosed during the pandemic.

Results: Out of 250 COVID positive mothers admitted, 55 COVID suspect neonates were admitted as their mothers were symptomatic. Among 55 suspect neonates, 11 turned out to be positive (20%). Out of 11 COVID positive neonates, tachypnea with requirement of non-invasive O2 in 2 (18%), feeding intolerance in 2 (18%), fever in 2 (18%) rash 1 (9%) was seen. out of the 11 COVID positive neonates admitted, 45% had elevated D-Dimer levels, 36% had elevated Leucocyte counts, 27% each had raised serum ferritin and fibrinogen levels and 18% had raised CRP Levels.

Conclusions: We conclude that inspite of the first wave of COVID seen in neonates which was rare then, clinical and laboratory markers showed a good co-relation in our study in all neonates who were COVID positive but there was no radiological co-relation in any. However, all recovered with symptomatic treatment without any specific COVID treatment.


COVID suspects, COVID positive, Neonate

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Yang Z, Liu Y. Vertical Transmission of Severe Acute Respiratory Syndrome Coronavirus 2: A Systematic Review. Am J Perinatol. 2020;37(10):1055-60.

Goh XL, Low YF, Ng CH. Arch Dis Child Fetal Neonatal Ed. 2020;0:F1-2.

Walker KF, O'Donoghue K, Grace N, Dorling J, Comeau JL, Li W, Thornton JG. Maternal transmission of SARS-COV-2 to the neonate, and possible routes for such transmission: a systematic review and critical analysis. BJOG. 2020;127:1324-36.

Anand P, Yadav A, Debata P, Bachani S, Gupta N, Gera R. Clinical profile, viral load, management and outcome of neonates born to COVID 19 positive mothers: a tertiary care centre experience from India. Eur J Pediatr. 2021;180(2):547-59.

Lavizzari A, Klingenberg C, Profit J. International comparison of guidelines for managing neonates at the early phase of the SARS-CoV-2 pandemic. Pediatr Res. 2021;89:940-51.

Chawla D, Chirla D, Dalwai S, Deorari AK, Ganatra A, Gandhi A, et al. Federation of Obstetric and Gynaecological Societies of India (FOGSI), National Neonatology Forum of India (NNF) and Indian Academy of Pediatrics (IAP). Perinatal-Neonatal Management of COVID-19 Infection - Guidelines of the Federation of Obstetric and Gynaecological Societies of India (FOGSI), National Neonatology Forum of India (NNF), and Indian Academy of Pediatrics (IAP). Indian Pediatr. 2020;57(6):536-48.

Cook J, Harman K, Zoica B, Verma A, D'Silva P, Gupta A. Horizontal transmission of severe acute respiratory syndrome coronavirus 2 to a premature infant: multiple organ injury and association with markers of inflammation. Lancet Child Adolesc Health. 2020;4(7):548-51.

National Neonatology Forum (Nnf) Covid-19 Registry Group. Outcomes of Neonates Born to Mothers with Coronavirus Disease 2019 (COVID-19) - National Neonatology Forum (NNF) India COVID-19 Registry. Indian Pediatr. 2021.

Kalamdani P, Kalathingal T, Manerkar S, Mondkar J. Clinical Profile of SARS-CoV-2 Infected Neonates From a Tertiary Government Hospital in Mumbai, India. Indian Pediatr. 2020;57(12):1143-6.

Hu Z, Song C, Xu C, Jin G, Chen Y, Xu X, Ma H, et al. Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China. Sci China Life Sci. 2020;63(5):706-11.

Zimmermann P, Curtis N. Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children. Pediatr Infect Dis J. 2020;39(5):355-68.

De Bernardo G, Giordano M, Zollo G, Chiatto F, Sordino D, De Santis R et al. The clinical course of SARS-CoV-2 positive neonates. J Perinatol. 2020;40(10):1462-69.

Wang S, Guo L, Chen L, Liu W, Cao Y, Zhang J, Feng L. A Case Report of Neonatal 2019 Coronavirus Disease in China. Clin Infect Dis. 2020;71(15):853-7.

Chen Y, Peng H, Wang L, Zhao Y, Zeng L, Gao H, Liu Y. Infants Born to Mothers With a New Coronavirus (COVID-19). Front Pediatr. 2020;8:104.

Amatya S, Corr TE, Gandhi CK, Glass KM, Kresch MJ, Mujsce DJ et al. Management of newborns exposed to mothers with confirmed or suspected COVID-19. J Perinatol. 2020;40(7):987-96.