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Characteristics and outcomes of neonates hospitalised with SARS-CoV-2 infection in the UK by variant: a prospective national cohort study.

Gale, C; Sharkey, D; Fitzpatrick, KE; Mactier, H; Morelli, A; Nakahara, M; Hurd, M; Placzek, A; Knight, M; Ladhani, SN; et al. Gale, C; Sharkey, D; Fitzpatrick, KE; Mactier, H; Morelli, A; Nakahara, M; Hurd, M; Placzek, A; Knight, M; Ladhani, SN; Draper, ES; Doherty, C; Quigley, MA; Kurinczuk, JJ; Neonatal complications of COVID-19 Collaborative Group (2024) Characteristics and outcomes of neonates hospitalised with SARS-CoV-2 infection in the UK by variant: a prospective national cohort study. Arch Dis Child Fetal Neonatal Ed, 109 (3). pp. 279-286. ISSN 1468-2052 https://doi.org/10.1136/archdischild-2023-326167
SGUL Authors: Ladhani, Shamez Nizarali

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Abstract

OBJECTIVE: Neonatal infection with wildtype SARS-CoV-2 is rare and good outcomes predominate. We investigated neonatal outcomes using national population-level data to describe the impact of different SARS-CoV-2 variants. DESIGN: Prospective population-based cohort study. SETTING: Neonatal, paediatric and paediatric intensive care inpatient care settings in the UK. PATIENTS: Neonates (first 28 days after birth) with confirmed SARS-CoV-2 infection who received inpatient care, March 2020 to April 2022. Neonates were identified through active national surveillance with linkage to national SARS-CoV-2 testing data, routinely recorded neonatal data, paediatric intensive care data and obstetric and perinatal mortality surveillance data. OUTCOMES: Presenting signs, clinical course, severe disease requiring respiratory support are presented by the dominant SARS-CoV-2 variant in circulation at the time. RESULTS: 344 neonates with SARS-CoV-2 infection received inpatient care; breakdown by dominant variant: 146 wildtype, 123 alpha, 57 delta and 18 omicron. Overall, 44.7% (153/342) neonates required respiratory support; short-term outcomes were good with 93.6% (322/344) of neonates discharged home. Eleven neonates died: seven unrelated to SARS-CoV-2 infection, four were attributed to neonatal SARS-CoV-2 infection (case fatality 4/344, 1.2% 95% CI 0.3% to 3.0%) of which three were born preterm due to maternal COVID-19. More neonates were born very preterm (23/54) and required invasive ventilation (27/57) when delta variant was predominant, and all four SARS-CoV-2-related deaths occurred in this period. CONCLUSIONS: Inpatient care for neonates with SARS-CoV-2 was uncommon. Although rare, severe neonatal illness was more common during the delta variant period, potentially reflecting more severe maternal disease and associated preterm birth. TRIAL REGISTRATION NUMBER: ISRCTN60033461.

Item Type: Article
Additional Information: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Keywords: COVID-19, epidemiology, neonatology, Neonatal complications of COVID-19 Collaborative Group, neonatology, COVID-19, epidemiology, 1114 Paediatrics and Reproductive Medicine, Pediatrics
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Arch Dis Child Fetal Neonatal Ed
ISSN: 1468-2052
Language: eng
Dates:
DateEvent
18 April 2024Published
15 November 2023Published Online
25 October 2023Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
PR-PRU-1217-21202National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
11/46/12National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
PubMed ID: 37968087
Web of Science ID: WOS:001104353700001
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/116327
Publisher's version: https://doi.org/10.1136/archdischild-2023-326167

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