From the Recep Tayyip Erdoğan University School of Medicine, Department of Pediatrics, Division of Neonatology, Rize.
Ministry of Health Ankara City Hospital, Division of Neonatology, Ankara.
Pediatr Infect Dis J. 2020 Oct;39(10):e297-e302. doi: 10.1097/INF.0000000000002862.
Coronavirus disease 2019 (COVID-19) primarily affects adults and spares children, whereas very little is known about neonates. We tried to define the clinical characteristics, risk factors, laboratory, and imagining results of neonates with community-acquired COVID-19.
This prospective multicentered cohort study included 24 neonatal intensive care units around Turkey, wherein outpatient neonates with COVID-19 were registered in an online national database. Full-term and premature neonates diagnosed with COVID-19 were included in the study, whether hospitalized or followed up as ambulatory patients. Neonates without severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) via reverse transcriptase-polymerase chain reaction testing or whose mothers had been diagnosed with COVID-19 during pregnancy were excluded.
Thirty-seven symptomatic neonates were included. The most frequent findings were fever, hypoxemia, and cough (49%, 41%, 27%, respectively). Oxygen administration (41%) and noninvasive ventilation (16%) were frequently required; however, mechanical ventilation (3%) was rarely needed. Median hospitalization was 11 days (1-35 days). One patient with Down syndrome and congenital cardiovascular disorders died in the study period. C-reactive protein (CRP) and prothrombin time (PT) levels were found to be higher in patients who needed supplemental oxygen (0.9 [0.1-8.6] vs. 5.8 [0.3-69.2] p = 0.002, 11.9 [10.1-17.2] vs. 15.2 [11.7-18.0] p = 0.01, respectively) or who were severe/critical (1.0 [0.01-8.6] vs. 4.5 [0.1-69.2] p = 0.01, 11.7 [10.1-13.9] vs. 15.0 [11.7-18.0] p = 0.001, respectively).
Symptomatic neonates with COVID-19 had high rates of respiratory support requirements. High CRP levels or a greater PT should alert the physician to more severe disease.
2019 年冠状病毒病（COVID-19）主要影响成人，而儿童受影响较小，而对于新生儿则知之甚少。我们试图确定社区获得性 COVID-19 新生儿的临床特征、危险因素、实验室和成像结果。
本前瞻性多中心队列研究纳入了土耳其各地的 24 个新生儿重症监护病房，其中在全国在线数据库中登记了门诊患有 COVID-19 的新生儿。本研究纳入了通过逆转录-聚合酶链反应检测确诊为 COVID-19 的足月和早产儿，无论是否住院或作为门诊患者进行随访。未通过逆转录-聚合酶链反应检测确诊为严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的新生儿或其母亲在怀孕期间被诊断为 COVID-19 的新生儿被排除在外。
共纳入 37 例有症状的新生儿。最常见的表现为发热、低氧血症和咳嗽（分别为 49%、41%和 27%）。经常需要吸氧（41%）和无创通气（16%），但很少需要机械通气（3%）。中位住院时间为 11 天（1-35 天）。在研究期间，1 例唐氏综合征合并先天性心血管疾病的患儿死亡。需要补充氧气的患者（0.9[0.1-8.6]vs.5.8[0.3-69.2]，p=0.002）或重症/危重症患者（0.9[0.1-8.6]vs.4.5[0.1-69.2]，p=0.01）的 C 反应蛋白（CRP）和凝血酶原时间（PT）水平更高，分别为 11.9[10.1-17.2]vs.15.2[11.7-18.0]，p=0.01 和 11.7[10.1-13.9]vs.15.0[11.7-18.0]，p=0.001。
有症状的 COVID-19 新生儿需要高比例的呼吸支持。高 CRP 水平或较大的 PT 应提醒医生注意更严重的疾病。
