Neonatal COVID-19 infection: Initial experience from a tertiary care centre in Northern India

Introduction: Data on COVID-19 transmission, manifestations and outcome for the neonatal population is scarce, particularly from developing country settings.

Objectives: To assess the transmission risk of SARS-CoV-2 in the mother-infant dyad and to describe the clinical profile of neonates born to COVID positive mothers in a tertiary care centre in Northern India.

Method: An observational cohort study was conducted in the neonatal COVID unit of All India Institute of Medical Sciences Patna, India. All neonates delivered by COVID-19 positive mothers at this hospital were admitted. During pandemic, admissions were also allowed for out-born neonates positive for SARS-CoV-2. COVID-19 RT-PCR on nasopharyngeal swab of neonate at 24 and 48-72 hours was primary outcome variable. Clinico-laboratory variables were collected during hospital stay and follow up. An inferential analysis was done using SPSS version 22.0.

Results:Fifty-one out of 145 (142 delivered at our institute and 3 at other institutes) pregnant women tested positive for COVID-19. Two in-born neonates and two out-born neonates also tested positive. They had a significantly higher respiratory rate (p=0.0006) as compared to COVID-19 negative new-borns. COVID-19 RT-PCR done on breast milk samples of twenty-five mothers, tested negative. One inborn COVID negative neonate born to COVID positive mother died of severe birth asphyxia due to meconium-stained liquor. One inborn COVID negative neonate born to COVID positive mother required 27 days of ventilator support due to meconium stained liquor. All other neonates, except two with risk factors, remained clinically stable requiring no specific treatment during hospital stay and follow-up.

Conclusions: With standard infection prevention and control practices, potential of infection transmission in neonates exists though they had less severe disease and needed no specific treatment except supportive care.

Sri Lanka Journal of Child Health, 2021; 50(3): 495-502