Characteristics and outcomes of neonatal SARS-CoV-2 infection in the United Kingdom: a prospective national cohort study using active surveillance
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background: Babies differ in their exposure to SARS-CoV-2relative to older children. There are limited data describing the impact of SARS-CoV-2 in this group and guidance is variable. Methods: ProspectiveUKpopulation-based cohort study of babies with confirmed SARS-CoV-2 infection in the first28 days that received inpatient care, 1st March 2020to30thApril 2020. Babies were identified through active national surveillance with linkage to national testing, paediatric intensive care audit and obstetric surveillance data. Outcomes included incidence per10,000 live births of inpatient hospital care with confirmed SARS-CoV-2 infection, severe disease, suspected vertically and nosocomially acquired infection. Findings: Sixty-six babies had SARS-CoV-2 infection and received inpatient care, an incidence of 5·6(95% CI 4·3, 7·1); 28 (42%) babies had severe neonatal SARS-CoV-2 infection, incidence 2·4 (95% CI 1·6, 3·4). Twenty-nine babies (45%) were from black, Asian or minority ethnic groups, an incidence of 11·1(95% CI 7·4, 15·9); incidence in white group 4·6(95% CI 3·2, 6·4). Sixteen(24%) babies were born preterm. Seventeen(26%) babies with confirmed infection were born to mothers with known perinatal SARS-CoV-2 infection. Two babies had possible vertically acquired infection and eight (12%) babies had suspected no socomial infection. Most babies (58, 88%) have been discharged home; one baby died of a cause unrelated to SARS-CoV-2 infection.Interpretation: Inpatient care in babies with neonatal SARS-CoV-2 infection is uncommon.Babies in hospital with SARS-CoV-2 infection were more likely to have severe disease than older children, although outcomes were good. Infection with neonatal admission following birth to a mother with perinatal SARS-CoV-2 infection was unlikely and possible vertical transmission rare, supporting international guidance to avoid separation of mother and baby. The high proportion of babies from black, Asian or minority ethnic groups requires investigation.
Date Issued
2021-02
Date Acceptance
2020-10-13
Citation
The Lancet Child and Adolescent Health, 2021, 5 (2), pp.113-121
ISSN
2352-4642
Publisher
Elsevier
Start Page
113
End Page
121
Journal / Book Title
The Lancet Child and Adolescent Health
Volume
5
Issue
2
Copyright Statement
© 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
License URL
Sponsor
National Institute of Health Research Policy Research Programme
Identifier
https://www.sciencedirect.com/science/article/pii/S2352464220303424?via%3Dihub
Grant Number
PR-PRU-1217-21202
Subjects
Science & Technology
Life Sciences & Biomedicine
Pediatrics
CARE
COVID-19
Cross Infection
Ethnic Groups
Female
Hospitalization
Humans
Incidence
Infant, Newborn
Infectious Disease Transmission, Vertical
Intensive Care, Neonatal
Male
Obstetrics
Pregnancy
Pregnancy Complications, Infectious
Premature Birth
SARS-CoV-2
United Kingdom
Humans
Cross Infection
Pregnancy Complications, Infectious
Premature Birth
Intensive Care, Neonatal
Hospitalization
Incidence
Obstetrics
Pregnancy
Infant, Newborn
Ethnic Groups
Female
Male
Infectious Disease Transmission, Vertical
United Kingdom
COVID-19
SARS-CoV-2
Publication Status
Published
Date Publish Online
2020-11-09