Section of Neonatology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA.
Children's Hospital Colorado, Aurora, Colorado, USA.
Neonatology. 2020;117(5):641-645. doi: 10.1159/000508962. Epub 2020 Jun 4.
The novel coronavirus 2019 (SARS-CoV-2) has been well described in adults. Further, the impact on older children and during the perinatal time is becoming better studied. As community spread increases, it is important to recognize that neonates are vulnerable to community spread as well. The impact that community-acquired SARS-CoV-2 has in the neonatal time period is unclear, as this population has unique immunity considerations.
To report on a case series of SARS-CoV-2 in neonates through community acquisition in the USA.
This is an early retrospective study of patients admitted to the Neonatal Intensive Care Unit (NICU) identified as having SAR-CoV-2 through positive real-time polymerase chain reaction assay of nasopharyngeal swabs.
Three patients who required admission to the NICU between the ages of 17 and 33 days old were identified. All 3 had ill contacts in the home or had been to the pediatrician and presented with mild to moderate symptoms including fever, rhinorrhea, and hypoxia, requiring supplemental oxygen during their hospital stay. One patient was admitted with neutropenia, and the other 2 patients became neutropenic during hospitalization. None of the patients had meningitis or multiorgan failure.
Infants with community-acquired SARS-CoV-2 may require hospitalization due to rule-out sepsis guidelines if found to have fever and/or hypoxia. Caregivers of neonates should exercise recommended guidelines before contact with neonates to limit community spread of SARS-CoV-2 to this potentially vulnerable population, including isolation, particularly as asymptomatic cases become prevalent.
新型冠状病毒 2019（SARS-CoV-2）在成人中已有很好的描述。此外，人们对年长儿童和围产期的影响的研究也越来越多。随着社区传播的增加，重要的是要认识到新生儿也容易受到社区传播的影响。由于这一人群有独特的免疫考虑因素，因此尚不清楚社区获得性 SARS-CoV-2 对新生儿时期的影响。
报告美国通过社区获得性传播的 SARS-CoV-2 在新生儿中的病例系列。
这是一项对通过鼻咽拭子实时聚合酶链反应检测呈阳性而被确认为 SARS-CoV-2 的新生儿重症监护病房（NICU）住院患者进行的早期回顾性研究。
共发现 3 名年龄在 17 至 33 天之间需要住院的患者。所有 3 名患者家中均有接触过的感染者，或去过儿科医生处就诊，表现为轻度至中度症状，包括发热、流涕和缺氧，在住院期间需要补充氧气。1 名患者伴有中性粒细胞减少症，另外 2 名患者在住院期间出现中性粒细胞减少症。所有患者均无脑膜炎或多器官衰竭。
如果发现有发热和/或缺氧，根据排除败血症指南，患有社区获得性 SARS-CoV-2 的婴儿可能需要住院治疗。新生儿的护理人员在与新生儿接触前应遵循建议的指南，以限制 SARS-CoV-2 在这一潜在脆弱人群中的社区传播，包括隔离，特别是在无症状病例增多的情况下。
