Clinicolaboratory Profile of and Outcomes in Neonates Born to COVID-19–Positive Mothers

Ram Narain Sehra, Alok Kumar Goyal, Rinku Saini, Suniti Verma, Sunil Gothwal, Raj Kumar Gupta, Manohar Lal Gupta

Abstract

Background and Aims: The novel coronavirus (COVID-19) infection and its mode of transmission, clinical manifestations, treatment, and outcomes are not studied much in newborns. Hence, the aim of this study was to find out the proportion of COVID-19–positive neonates born to COVID-19–positive mothers and to assess clinicolaboratory profile of and outcomes in neonates born to COVID-19–positive mothers.

Materials and Methods: This was a hospital-based retrospective observational study conducted from April 13, 2020, to July 31, 2020, at the NICU of a tertiary care hospital. A total of 120 neonates born to COVID-19–positive mothers were enrolled in this study. These neonates were monitored for COVID-19 symptoms, investigated (using throat swab reverse transcriptase polymerase chain reaction [RT-PCR] test), and treated, if required. 2 test was used for statistical analysis.

Results: The male-to-female ratio was 3:2 in the study population. Of the 120 neonates, 15% were preterms, 25% were of low birth weight, and 55.8% were delivered through vaginal deliveries. Only 5 (4.2%) of the 120 neonates tested positive for COVID-19. The COVID-19–positive neonates remained asymptomatic and were discharged after 2 consecutive negative RT-PCR reports. The first RT-PCR sample was sent at NICU admission, and the second RT-PCR sample was sent at 72 hours after the first positive report. In case of a nonconclusive report, RT-PCR test was repeated. The average duration of hospital stay was 10 days. Among the COVID-19–positive neonates, both leukopenia and lymphopenia were observed in 80%, increased C-reactive protein (CRP) and D-dimer levels in 60%, and increased fibrin degradation products’ (FDPs) levels were found in 40%. The COVID-19–negative neonates (n = 115) did not have symptoms related to COVID-19 but were found to have other illnesses, that is, 4.4% had transient tachypnea of the newborn, 1.7% had septicemia, and 0.9% had birth asphyxia. Of the COVID-19–negative neonates, 2.6% died because of birth asphyxia and septicemia, and the remaining 93.4% were discharged. The mean duration of the first COVID-19 positivity, hospital stay, and viral clearance was 5.4, 10, and 5.6 days, respectively, in our study.

Conclusion: Among the study population, the proportion of COVID-19 positivity was low (P = 4.2). Leukopenia, lymphopenia, and raised levels of CRP, FDP, and D-dimer were the main laboratory findings in COVID-19–positive neonates. All the COVID-19–positive neonates remained asymptomatic during the study. Vaginal delivery did not increase the risk of COVID-19 infection. The mean duration of COVID-19 positivity, hospital stay, and viral clearance was 5.4, 10, and 5.6 days, respectively, in our study.