Synthesis and systematic review of reported neonatal SARS-CoV-2 infections

Nat Commun. 2020 Oct 15;11(1):5164. doi: 10.1038/s41467-020-18982-9.

Abstract

A number of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections have been reported in neonates. Here, we aim to clarify the transmission route, clinical features and outcomes of these infections. We present a meta-analysis of 176 published cases of neonatal SARS-CoV-2 infections that were defined by at least one positive nasopharyngeal swab and/or the presence of specific IgM. We report that 70% and 30% of infections are due to environmental and vertical transmission, respectively. Our analysis shows that 55% of infected neonates developed COVID-19; the most common symptoms were fever (44%), gastrointestinal (36%), respiratory (52%) and neurological manifestations (18%), and lung imaging was abnormal in 64% of cases. A lack of mother-neonate separation from birth is associated with late SARS-CoV-2 infection (OR 4.94 (95% CI: 1.98-13.08), p = 0.0002; adjusted OR 6.6 (95% CI: 2.6-16), p < 0.0001), while breastfeeding is not (OR 0.35 (95% CI: 0.09-1.18), p = 0.10; adjusted OR 2.2 (95% CI: 0.7-6.5), p = 0.148). Our findings add to the literature on neonatal SARS-CoV-2 infections.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Betacoronavirus / genetics
  • Betacoronavirus / immunology
  • Betacoronavirus / isolation & purification
  • COVID-19
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / pathology*
  • Coronavirus Infections / transmission*
  • Female
  • Humans
  • Infant, Newborn
  • Lung / diagnostic imaging
  • Lung / pathology
  • Maternal Exposure / adverse effects
  • Pandemics
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / pathology*
  • Pneumonia, Viral / transmission*
  • SARS-CoV-2