Neonatal and Young Infants’ Sepsis: A Grab Attention Comparative Study among COVID-19 Positive and Negative Cases in the State of Qatar

Background: Coronavirus disease-2019 (COVID-19)had spectrum of manifestations ranging from mild upper respiratory infection to severe pneumonitis, acute respiratory distress syndrome and death. Few cases have been observed in children who seem to have favorable clinical course than other age groups, and even fewer in newborn babies however limited data are available about the clinical course in symptomatic young infants with COVID19-infection.

Methods: Controlled single institutional retrospective study conducted in April 1st-July2020 at Hamad Medical Center, Qatar. It included all infants

Result: 81 patients were studied, (41)COVID-19-positive and (40)negative. Male: female ratio (0.8:)in both group. COVID19-positive group were older than the negative group (mean age 32 versus 17 days respectively)(p <0.01). Fever was present in 90 % of COVID19-positive infants versus 80%of the negative group(table1). COVID19-positive infants had higher occurrence of nasal congestion and cough (39% and 29% respectively) versus the negative group (20% and 3% respectively)(P <0.05). 15%among COVID-19-positive had diarrhea versus8%of the negative group. Vomiting occurred in7%of the COVID19-positive infants versus5%in negative group. Poor feeding, hypo-activity were significantly higher in COVID negative group(58%and45% respectively)versus the positive group(22%and12% respectively)(P-value 0.0004). Sepsis-workup and lumbar puncture (LP) were performed in 27(67%) COVID-19-positive and92%of the negative group. 26/27of CSF cultures were negative in the COVID-19-positive(1case had Klebsiella meningitis). All COVID19 negative group had negative CSF cultures. COVID19-positive group received antibiotics for 3.5 days vs the negative group(7.5 days). (P0.02)(table 2)

Conclusion: In this cohort, 41/81 infants(51%) presented with early-onset sepsis-like picture were COVID19-positive. Our study showed that COVID-positive presentation in neonates might simulate sepsis like picture due to other causes. Screening newborns with sepsis-like picture for COVID19-is necessary during this epidemic.