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.