COVID-19 Publications

5

May, 2020

Severe neutropenia in infants with severe acute respiratory syndrome caused by the novel coronavirus 2019 infection

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Infection with severe acute respiratory syndrome caused by the novel coronavirus 2019 (SARS-CoV-2) and resulting coronavirus disease 2019 (COVID-19) is a global pandemic. Pediatric cases have some peculiarities, such as milder clinical manifestations and different laboratory abnormalities. A systematic review on laboratory data identified 12 articles, with a total of 66 pediatric patients. Lymphopenia was found in only 3% of children, whereas lymphopenia often is described in adult patients. Neutropenia was recorded in 6% of cases, but it was never less than 0.500 x 109 /L in this population.

We describe a 23-day-old and a 39-day-old infant with mild COVID-19 and severe neutropenia who were cared for at our tertiary care referral pediatric hospital.

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5

May, 2020

Dynamic viral SARS-CoV-2 RNA shedding in children: preliminary data and clinical consideration of Italian regional center

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We evaluated SARS-CoV-2-RNA clearance in 22 children . The estimation of positivity at day 14 from symptom onset is 52% for nasopharyngeal swab and 31% for stool swab. These data underline the significance of nasopharyngeal and stool swab for detecting infected children; further studies are needed for transmissibility.

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28

Apr, 2020

Clinical characteristics and risk assessment of newborns born to mothers with COVID-19

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Background Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is causing an outbreak of pneumonia in Wuhan, Hubei Province, China, and other international areas.

Objective Here, we report the clinical characteristics of the newborns delivered by SARS-CoV-2 infected pregnant women.

Methods We prospectively collected and analyzed the clinical features, laboratory data and outcomes of 7 newborns delivered by SARS-CoV-2 infected pregnant women in Zhongnan Hospital of Wuhan University during January 20 to January 29, 2020.

Results 4 of the 7 newborns were late preterm with gestational age between 36 weeks and 37 weeks, and the other 3 were full-term infants. The average birth weight was 2096 ± 660 g. All newborns were born without asphyxia. 2 premature infants performed mild grunting after birth, but relieved rapidly with non-invasive continuous positive airway pressure (nCPAP) ventilation. 3 cases had chest X-ray, 1 was normal and 2 who were supported by nCPAP presented mild neonatal respiratory distress syndrome (NRDS). Samples of pharyngeal swab in 6 cases, amniotic fluid and umbilical cord blood in 4 cases were tested by qRT-PCR, and there was no positive result of SARS-CoV-2 nucleic acid in all cases.

Conclusions The current data show that the infection of SARS-CoV-2 in late pregnant women does not cause adverse outcomes in their newborns, however, it is necessary to separate newborns from mothers immediately to avoid the potential threats.

 

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17

Apr, 2020

Preterm delivery in pregnant women with critical COVID-19 pneumonia and vertical transmission

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Since December 2019, the novel coronavirus disease (COVID-19) infection has spread quickly from China to different parts of the world including Iran . Since February 18, 2020, over 12,000 confirmed cases of COVID-19 have been reported in Iran, and more than 150,000 cases in numerous other countries worldwide, with an around 3-4% mortality rate as up to March 15. One of the most important ways of viral transmission is the individuals contact in hospitals, inside families, and other crowded places, but still no finding is reported on the optimal treatment modalities or vaccines,

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15

Apr, 2020

COVID‐19 in pregnancy with comorbidities: more liberal testing strategy is needed

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Abstract Despite a global pandemic, reports on pregnant women with Coronavirus disease 2019 (COVID‐19) are few so far, testing strategies vary substantially and management guidelines are not uniform.

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15

Apr, 2020

Lung ultrasound and computed tomographic findings in pregnant woman with COVID‐19

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Abstract Imaging modalities play a crucial role in the management of suspected COVID‐19‐infected patients. Before reverse transcription polymerase chain reaction (RT‐PCR) test results are positive, 60–93% of patients have positive chest computed tomographic (CT) findings consistent with COVID‐19 infection. We report a case of positive lung ultrasound findings consistent with COVID‐19 in a woman with an initial negative RT‐PCR result. The lung ultrasound‐imaging findings were present between the negative and subsequent positive RT‐PCR tests and correlated with CT findings. The point‐of‐care lung‐ultrasound examination was easy to perform and, as such, could play an important role in the triage of women with suspected COVID‐19. The neonatal swabs, cord blood, and placental swab RT‐PCR tests were negative for SARS‐CoV‐2, a finding consistent with the published literature suggesting no vertical transmission of SARS‐CoV‐2 in pregnant women.

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15

Apr, 2020

Novel coronavirus in a 15-day-old neonate with clinical signs of sepsis, a case report

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Introduction Novel coronavirus or coronavirus disease (COVID-19) can affect all age groups. The clinical course of the disease in children and infants is milder than in adults. It should be noted that, although typical symptoms may be present in children, non-specific symptoms could be noted in the neonate. The disease is rare in the neonate, so, its suspicion in this group can help to make a quick diagnose.

Case report A 15-day-old neonate was admitted with fever, lethargy, cutaneous mottling, and respiratory distress without cough. His mother had symptoms of Novel coronavirus. So Reverse-Transcription Polymerase Chain Reaction (RT-PCR) assay was done for the neonate and showed to be positive. The newborn was isolated and subjected to supportive care. Antibiotic and antiviral treatment was initiated. Eventually, the baby was discharged in good general condition.

Conclusion When a newborn presents with non-specific symptoms of infection with an added history of COVID-19 in his/her parents, it indicates the need for PCR testing for Novel coronavirus.

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15

Apr, 2020

COVID‐19 infection in a paucisymptomatic infant: raising the index of suspicion in epidemic settings

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Abstract Few children have been reported to have been affected by novel coronavirus disease 2019 (COVID-19); it is unclear whether children are less likely to be infected or rather display fewer symptoms. We present the case of a 32-day-old boy infected by COVID-19 that presented with an upper air way infection which resolved spontaneously and did not require any therapy. We argue that in epidemic settings children presenting with any mild symptom potentially attributable to COVID-19 should be considered contagious until proven otherwise, and that management must be guided by clinical conditions.

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6

Apr, 2020

Asymptomatic COVID-19 infection in late pregnancy indicated no vertical transmission

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Abstract This study is to investigate the clinical characteristics of late pregnancy with asymptomatic 2019 novel coronavirus disease (COVID‐19) infection, evaluate the outcome of maternal and fetal prognosis, and identify the evidence of intrauterine vertical transmission. A 22‐years‐old pregnant woman with asymptomatic COVID‐19 infection who was admitted to our hospital on 11 February 2020 was enrolled in this study. Clinical data including laboratory test results and chest computed tomography (CT) scanning were collected and reviewed. Diagnosis of late pregnancy with asymptomatic COVID‐19 infection was made. Lumbar anesthesia for cesarean section was performed and a female baby was delivered uneventfully, with the Apgar score of 9 to 10 points. Three times of COVID‐19 nucleic acid test for the baby was negative after delivery. The puerpera returned to normal after the operation and two times of throat swab COVID‐19 nucleic acid test were all negative after antiviral therapy. We reported an asymptomatic COVID‐19 pregnant woman with detailed clinical information and our result indicated that for late pregnant women with asymptomatic COVID‐19 infection, there might be no intrauterine infection caused by vertical transmission.

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31

Mar, 2020

Clinical characteristics of novel coronavirusdisease 2019 (COVID-19) in newborns, infants and children

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Abstract Since December 2019, a novel coronavirus disease 2019 (COVID-19) caused by a novel coronavirus, SARS-CoV-2, has been emerging in Wuhan, Hubei Province, China. It has spread to other areas of China and further to more than 40 countries and regions around the world. In Singapore, Japan, Korea, Italy, and Thailand, there have been community-based infections. A few cases of pneumonia in children with SARS-CoV-2 infection were reported. Pediatric cases are mainly family cluster cases, and most of them have epidemiological links to adult patients. Pediatric clinical manifestations are not typical, and relatively milder, compared with that of adult patients.

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