Effects on Fetus & Neonates of COVID-19
Despite many authors not reporting adverse neonatal outcomes, Zhu et al.
reported one neonatal death among six neonates who were tested positive
for COVID-19 at their neonatal intensive care unit. The first symptom in
all the newborns was shortness of breath, followed by fever,
thrombocytopenia accompanied by abnormal liver function, tachycardia,
vomiting, and pneumothorax. The authors reported that 6 out of 10
neonates admitted to their center were born prematurely and 8 out of 10
were delivered by Cesarean section, the two important predictors of
adverse outcomes, as per the authors14,
31.
Shwartz et al. reported extensive neonatal outcomes in children born to
COVID-19 positive mothers. Authors reported cases of 10 children who
were evaluated using the Pediatric Critical Illness Score (PCIS). Six of
the newborns had a PCIS of less than 90 (the lesser the scores, the
worse the predicted outcomes) with 6 infants developing shortness of
breath, two were febrile and one of them had a significant tachycardia.
Gastrointestinal symptoms such as gastric bleeding, refusal to feed,
feeding intolerance and abdominal bloating was observed in 4 infants.
The chest radiograph abnormalities in 7 newborns at the time of
admission comprised of infection in 4, neonatal respiratory distress
syndrome in 2 and pneumothorax in 1 infant. Two infants had the onset of
thrombocytopenia associated with liver dysfunction. One premature infant
developed shortness of breath and fluctuations of oxygenation with
decreased platelets and was treated with respiratory support and
transfusions accordingly. There was one neonatal fatality among the
cohort, that of a premature child. Pharyngeal swab specimens were
collected from 9 of the neonates between 1- and 9-days following
delivery and tested for SARS-CoV-2, and all were negative17.