key: cord-0873546-aceqscdx
authors: Sutton, Hannah J.; Dargaville, Peter A.; Spotswood, Naomi E.
title: Unravelling the epidemiology and clinical impact of SARS‐CoV‐2 infection in neonates
date: 2021-05-29
journal: Acta Paediatr
DOI: 10.1111/apa.15899
sha: 8a7ebc490ee809d4d42194ec8689c353958ee2ca
doc_id: 873546
cord_uid: aceqscdx

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The impact of the SARS-CoV-2 pandemic has transformed the means by which health care is delivered, including perinatal care.

Given neonates have unique vulnerabilities to acquiring infections, 1 determining optimal practices to prevent and respond to neonatal SARS-CoV-2 infections has been an area of much discussion and debate amongst perinatal healthcare providers.

Published information on the clinical characteristics and mode of acquisition for neonatal SARS-CoV-2 infection was scarce earlier in the pandemic, largely limited to case reports. An early cohort study from China revealed higher disease severity in young infants than older children, by criteria which defined severe and critical cases as including early respiratory and in some cases gastrointestinal symptoms, or progression to severe respiratory or systemic illness, respectively. 2 Gale et al.'s paper presents data from a peak period of SARS-CoV-2 infection in the United Kingdom (UK) and is an important contribution to our understanding of the incidence, disease severity and transmission modes for neonatal SARS-CoV-2 infection. This study found that COVID-19 disease severe enough to require hospitalisation was rare in neonates, at 5.6 per 10 000 livebirths. While many infections were mild, the study confirms a higher propensity to severe disease in neonates than older children. 2,3 42% of cases were defined as severe, albeit using criteria that may include neonates who, while unwell, would not necessarily require intensive care. This paper also highlights inequality in disease incidence for SARS-CoV-2 for babies of Black, Asian and Minority Ethnic (BAME) groups, with an incidence three to four-fold that of individuals classified as having white ethnicity. This finding is not isolated to neonates, with a disproportionately high disease incidence amongst individuals of BAME groups amongst pregnant women and wider adult populations. 6, 7 This observation is a substantial public health concern that likely speaks to the influence of social determinants of health. 

Immunological defects in neonatal sepsis and potential therapeutic approaches

Epidemiology of COVID-19 among children in China

Clinical characteristics of children and young people admitted to hospital with COVID-19 in United Kingdom: prospective multicenter observational cohort study

Breastfeeding and COVID-19: Scientific brief. 2020 World Health Organization

Preterm care during the COVID-19 pandemic: a comparative risk analysis of neonatal deaths averted by kangaroo mother care versus mortality due to SARS-CoV-2 infection

Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study

Racial and ethnic disparities in SARS-CoV-2 pandemic: analysis of a COVID-19 observational registry for a diverse US metropolitan population

Unravelling the epidemiology and clinical impact of SARS-CoV-2 infection in neonates

Providers of perinatal health care still have much to learn about SARS-CoV-2. Ongoing collection and analysis of comprehensive perinatal epidemiologic data will remain paramount for our capacity to respond this pandemic in a manner that is well-informed, evidence-based and effective in optimising the health and wellbeing of all mothers and babies affected.

None to declare.