Mehmet Kenan Kanburoglu1, Cuneyt Tayman2, Mehmet Yekta Oncel3,4, Ilke Mungan Akin5, Emrah Can6, Nihat Demir7, Sema Arayici8, Demet Orhan Baser9, Ibrahim Caner10, Asli Memisoglu11, Saime Sundus Uygun12, Selahattin Akar13, Mustafa Ali Akin14, Emel Ataoglu15, Handan Bezirganoglu16, Leyla Bilgin17, Senol Bozdag18, Serdar Comert19, Resat Gurpinar20, Ebru Yalin Imamoglu21, Timucin Imdadoglu22, Fatma Narter23, Ramazan Ozdemir24, Handan Hakyemez Toptan25, Emine Esin Yalinbas26, Akan Yaman27, Omer Erdeve28, Esin Koc29. 1. From the Recep Tayyip Erdoğan University School of Medicine, Department of Pediatrics, Division of Neonatology, Rize. 2. Ministry of Health Ankara City Hospital, Division of Neonatology, Ankara. 3. İzmir Katip Celebi University School of Medicine, Department of Pediatrics, Division of Neonatology, Izmir. 4. University of Health Sciences, Tepecik Training and Research Hospital, Division of Neonatology, Izmir. 5. University of Health Sciences, Umraniye Training and Research Hospital, Division of Neonatology, Istanbul. 6. University of Health Sciences, Bagcilar Training and Research Hospital, Division of Neonatology, Istanbul. 7. Ozel Esencan Hospital, Division of Neonatology, Esenyurt, Istanbul. 8. Ministry of Health Eskisehir City Hospital, Division of Neonatology, Eskisehir. 9. Batman Obstetric ve Pediatric Hospital, Division of Neonatology, Batman. 10. Sakarya University School of Medicine, Department of Pediatrics, Division of Neonatology, Sakarya. 11. Marmara University School of Medicine, Department of Pediatrics, Division of Neonatology, İstanbul. 12. Ministry of Health Kahramanmaras Necip Fazil City Hospital, Division of Neonatology, Kahramanmaras. 13. Adiyaman University School of Medicine, Department of Pediatrics, Division of Neonatology, Adiyaman. 14. On dokuz Mayis University School of Medicine, Department of Pediatrics, Division of Neonatology, Samsun. 15. Ministry of Health Haseki Training and Research Hospital, Division of Neonatology, Istanbul. 16. University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Diyarbakir. 17. Istanbul University School of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul. 18. Istanbul Okan University, Department of Pediatrics, Division of Neonatology, Istanbul. 19. University of Health Sciences, Istanbul Training and Research Hospital, Istanbul. 20. Kocaeli University School of Medicine, Department of Pediatrics, Division of Neonatology, Kocaeli. 21. Medeniyet University School of Medicine, Goztepe Training and Research Hospital, Istanbul. 22. University of Health Sciences, Sancaktepe Training and Research Hospital, Division of Neonatology, Istanbul. 23. Ministry of Health Kartal Dr. Lütfi Kirdar City Hospital, Division of Neonatology, Istanbul. 24. Inonu University School of Medicine, Department of Pediatrics, Division of Neonatology, Malatya. 25. University of Health Sciences, İstanbul Zeynep Kamil Training and Research Hospital, Division of Neonatology, Istanbul. 26. University of Health Sciences, Evliya Celebi Training and Research Hospital, Division of Neonatology, Kutahya. 27. Nişantaşi University School of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul. 28. Ankara University School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara. 29. Gazi University School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
BACKGROUND: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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.