The Characteristic of Biochemical Alterations In COVID-19 Neonate and Young Infant with Sepsis Like Picture in Compression to Negative One: Controlled Study

Background: Since the announcement of COVID-19-infection as pandemic in March 2020, multiple described it’s presentations in adults and children however very limited data described it’s manifestations in very young infants. Our aim was to describe the biochemical profile of symptomatic COVID-19-positive newborns who presented with sepsis like-picture in comparison to COVID-19-negative newborns.

Methods: A controlled single institutional retrospective study performedApril 1st - July 2020 at Hamad Medical Center, Qatar. All infants < 8 weeks of age admitted with sepsis-like picture were studied. They were divided into COVID-19-positive PCR (nasal swab) group and COVID-negative one (control). Details of biochemical chemistry across the groups were recorded and compared.

Results: Eighty-one newborns were studied: 40 control (COVID-negative) and 41 COVID-positive. White cell counts found to be lower in the positive compared to the negative group (mean 8.42vs12.5×109/L respectively)(P 0.0001). Lymphocyte % were higher in COVID-positive vs the negative group(59%vs41% respectively).The ANC neutrophil count was lower in the positive versus the negative group (mean=2×109/L vs5×109/L respectively(P 0.0001). Serum albumin was lower in COVID-19-positive versus negative group(mean =35 g/L versus44 g/L respectively)(P 0.0001). Sepsis-workup and lumbar puncture (LP)performed in 27of COVID-19-positive newborns and in all the negative group. 26/27 of CSF cultures were negative in the COVID-19-positive group(1-case had Klebsiella meningitis). All the COVID-19-negative group had negative CSF cultures. Both groups had negative blood cultures. Nine of the COVID-negative group had positive urine cultures while none of the COVID-positive.

4 of the COVID-negative group showed Rhino virus in their respiratory viral screening. The mean viral load(CT value)for COVID-19-positive group was low of-17.

Conclusion: Newborns and young infants who presented with sepsis like and were COVID-19-positive had significantly lower neutrophil count and albumin level and higher lymphocytic count compared to COVID-19-negative infants. Their low CT vale denoted considerably high viral load.