Abstract
Background
Limited evidence exists on perinatal transmission and outcomes of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in neonates.
Objective
To describe clinical outcomes and risk factors for transmission in neonates born to mothers with perinatal SARS-CoV-2 infection.
Design
Prospective cohort of suspected and confirmed SARS-CoV-2 infected neonates entered in National Neonatology Forum (NNF) of India registry.
Subjects
Neonates born to women with SARS-CoV-2 infection within two weeks before or two days after birth and neonates with SARS-CoV-2 infection.
Outcomes
Incidence and risk factors of perinatal transmission.
Results
Among 1713 neonates, SARS-CoV-2 infection status was available for 1330 intramural and 104 extramural neonates. SARS-CoV-2 positivity was reported in 144 intramural and 39 extramural neonates. Perinatal transmission occurred in 106 (8%) and horizontal transmission in 21 (1.5%) intramural neonates. Neonates roomed-in with mother had higher transmission risk (RR1.16, 95% CI 1.1 to 2.4; P=0.01). No association was noted with the mode of delivery or type of feeding. The majority of neonates positive for SARS-CoV2 were asymptomatic. Intramural SARS-CoV-2 positive neonates were more likely to be symptomatic (RR 5, 95%CI 3.3 to 7.7; P<0.0001) and need resuscitation (RR 2, 95%CI 1.0 to 3.9; P=0.05) compared to SARS-CoV-2 negative neonates. Amongst symptomatic neonates, most morbidities were related to prematurity and perinatal events.
Conclusion
Data from a large cohort suggests perinatal transmission of SARS-CoV-2 infection and increased morbidity in infected infants.
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Acknowledgements
Bodhgire Sachin and Aradhana Mishra, Government Medical College, Aurangabad, Maharashtra; Tanmay Sar and Bilkish Islam, Nil Ratan Sircar Medical College, Kolkata, West Bengal; Vivek Kumar and Dhirendra Prasad Yadav, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi; Md Zakiulla and Purbasha Mishra, All India Institute of Medical Sciences, Bhubaneswar, Odisha.
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List of group members provided as Annexure
Contributors
KM: initiated and wrote the proposal for the registry and created a data collection form, analyzed the data, and finalized the first draft of the manuscript; BT, SM and PK: facilitated the creation of the data registry on web-portal hosted by the Indian Neonatal Collaborative (INCC), India; BT: coordinated data collection and helped to extract relevant data from the portal; SM: wrote the introduction and methods sections, helped in biostatistics and approved the final draft of the manuscript; DC: reviewed the analysis, results section and wrote an interpretation of data and discussion; AD: approved the proposal, encouraged and coordinated hospitals’ participation through National Neonatology Forum, India and reviewed the final draft of the manuscript; PK: approved the proposal, created a registry on the portal, encouraged hospitals’ participation and approved the final draft of the manuscript. All the remaining Collaborators contributed significantly towards data collection and sharing from their respective institutes, and also reviewed and approved the final draft of the manuscript.
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National Neonatology Forum (NNF) COVID-19 Registry Group., Kumar, P., More, K. et al. Outcomes of Neonates Born to Mothers With Coronavirus Disease 2019 (COVID-19) — National Neonatology Forum (NNF) India COVID-19 Registry. Indian Pediatr 58, 525–531 (2021). https://doi.org/10.1007/s13312-021-2234-2
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DOI: https://doi.org/10.1007/s13312-021-2234-2