The course of new coronavirus infection in newborn infants

Introduction. To assess the features of the course of new coronavirus infection over the first month of life.

Materials and methods. The article presents four clinical cases of coronavirus infection in newborn children aged 8 to 30 days, treated at the covid centre of the National Medical Research Center for Children’s Health.

Results. The incubation period lasted from 2 to 10 days. The clinical picture included prevalence of hyperemic palatine arches, lethargy, impaired sucking, hyperemia of the conjunctiva, sneezing, mucous discharge from the nose, cough of varying severity. In more severe cases, an elevation in body temperature, a change in the auscultatory picture of lungs, abnormalities in the electrocardiogram. In the general blood test, there was noted anaemia, relative and absolute neutropenia, lymphocytosis and monocytosis; enlargement of аctivated partial thromboplastin time, increasing the level of D-dimer in the coagulogram. Computed tomography of the chest showed focal infiltrative changes in the lung tissue or uneven pneumatisation.

Conclusion. Our observations show coronavirus infection in newborns, most often to show a mild and moderate course, which does not require the appointment of antibacterial drugs and hormonal, and anticoagulant therapy without strict indications. According to the recommendations of the World Health Organization, the mother, and baby should remain together throughout the day, regardless of the suspicion or confirmation of a viral infection. To date, there is no conclusive evidence mother-to-child transmission of COVID-19 through breastfeeding is possible, and the benefits of breastfeeding far outweigh the minimal risk of infection. In addition, IgA and IgG to SARS-CoV-2, detected in milk, neutralise the effect of the virus.

Contribution:
Kharitonova N.A. — concept and design of the study;
Illarionova M.S., Nesterovich M.I., Mitish M.D., Seliverstova A.A. — collection and processing of the material;
Kharitonova N.A., Basargina M.A. — statistical processing;
Kharitonova N.A. — writing the text;
Basargina M.A. — editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received:  January 20, 2022
Accepted: February 17, 2022
Published: March 15, 2022

1. Esposito S., Marchetti F., Lanari M., Caramelli F., De Fanti A., Vergine G., et al. Efficient maternal to neonatal transfer of antibodies against SARS-CoV-2 and BNT162b2 mRNA COVID-19 vaccine. J. Clin. Invest. 2021; 131(13): e150319. https://doi.org/10.1172/JCI150319

2. Vergine G., Fantini M., Marchetti F., Stella M., Valletta E., Biasucci G., et al. COVID-19 management in the pediatric age: consensus document of the COVID-19 working group in paediatrics of the Emilia-Romagna region (RE-CO-Ped), Italy. Int. J. Environ. Res. Public Health. 2021; 18(8): 3919. https://doi.org/10.3390/ijerph18083919

3. Sankaran D., Nakra N., Cheema R., Blumberg D., Lakshminrusimha S. Perinatal SARS-CoV-2 infection and neonatal COVID-19: A 2021 update. Neoreviews. 2021; 22(5): e284–95. https://doi.org/10.1542/neo.22-5-e1001

4. Kharitonova N.A., Basargina M.A., Illarionova M.S., Nesterovich M.I. Features of the course of new coronavirus infection in newborns and first-year infants. Rossiyskiy pediatricheskiy zhurnal. 2021; 24(3): 203–8. https://doi.org/10.46563/1560-9561-2021-24-3-203-208 (in Russian)

5. Auriti C., De Rose D.U., Mondì V., Stolfi I., Tzialla C. Neonatal SARS-CoV-2 infection: practical tips. Pathogens. 2021; 10(5): 611. https://doi.org/10.3390/pathogens10050611

6. Pereda R., González D., Rivero H.B., Rivero J.C., Pérez A., López L.D.R., et al. Therapeutic effectiveness of interferon-α2b against COVID-19: the Cuban experience. J. Interferon Cytokine Res. 2020; 40(9): 438–42. https://doi.org/10.1089/jir.2020.0124

7. Erdeve Ö., Çetinkaya M., Baş A.Y., Narlı N., Duman N., Vural M., et al. The Turkish Neonatal Society proposal for the management of COVID-19 in the neonatal intensive care unit. Turk. Pediatri Ars. 2020; 55(2): 86–92. https://doi.org/10.14744/TurkPediatriArs.2020.43788

8. Salvatori G., De Rose D.U., Concato C., Alario D., Olivini N., Dotta A., et al. Managing COVID-19-positive maternal-infant dyads: an Italian experience. Breastfeed. Med. 2020; 15(5): 347–8. https://doi.org/10.1089/bfm.2020.0095

9. Lackey K.A., Pace R.M., Williams J.E., Bode L., Donovan S.M., Järvinen K.M., et al. SARS-CoV-2 and human milk: What is the evidence? Matern. Child Nutr. 2020; 16(4): e13032. https://doi.org/10.1111/mcn.13032

10. Shah M.D., Saugstad O.D. Newborns at risk of Covid-19 – lessons from the last year. J. Perinat. Med. 2021; 49(6): 643–9. https://doi.org/10.1515/jpm-2021-0258

11. World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. Interim guidance. Pediatr. Med. Rodz. 2020; 16(1): 9–26. https://doi.org/10.15557/PiMR.2020.0003