Characteristics and outcomes of neonatal SARS-CoV-2 infection in the UK: a prospective national cohort study using active surveillance
Babies differ from older children with regard to their exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, data describing the effect of SARS-CoV-2 in this group are scarce, and guidance is variable. We aimed to describe the incidence, characteristics, transmission, an...
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| Veröffentlicht in: | The lancet child & adolescent health 2021-02, Vol.5 (2), p.113-121 |
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| creator | Gale, Chris Quigley, Maria A Placzek, Anna Knight, Marian Ladhani, Shamez Draper, Elizabeth S Sharkey, Don Doherty, Cora Mactier, Helen Kurinczuk, Jennifer J |
| description | Babies differ from older children with regard to their exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, data describing the effect of SARS-CoV-2 in this group are scarce, and guidance is variable. We aimed to describe the incidence, characteristics, transmission, and outcomes of SARS-CoV-2 infection in neonates who received inpatient hospital care in the UK.
We carried out a prospective UK population-based cohort study of babies with confirmed SARS-CoV-2 infection in the first 28 days of life who received inpatient care between March 1 and April 30, 2020. Infected babies were identified through active national surveillance via the British Paediatric Surveillance Unit, with linkage to national testing, paediatric intensive care audit, and obstetric surveillance data. Outcomes included incidence (per 10 000 livebirths) of confirmed SARS-CoV-2 infection and severe disease, proportions of babies with suspected vertically and nosocomially acquired infection, and clinical outcomes.
We identified 66 babies with confirmed SARS-CoV-2 infection (incidence 5·6 [95% CI 4·3–7·1] per 10 000 livebirths), of whom 28 (42%) had severe neonatal SARS-CoV-2 infection (incidence 2·4 [1·6–3·4] per 10 000 livebirths). 16 (24%) of these babies were born preterm. 36 (55%) babies were from white ethnic groups (SARS-CoV-2 infection incidence 4·6 [3·2–6·4] per 10 000 livebirths), 14 (21%) were from Asian ethnic groups (15·2 [8·3–25·5] per 10 000 livebirths), eight (12%) were from Black ethnic groups (18·0 [7·8–35·5] per 10 000 livebirths), and seven (11%) were from mixed or other ethnic groups (5·6 [2·2–11·5] per 10 000 livebirths). 17 (26%) babies with confirmed infection were born to mothers with known perinatal SARS-CoV-2 infection, two (3%) were considered to have possible vertically acquired infection (SARS-CoV-2-positive sample within 12 h of birth where the mother was also positive). Eight (12%) babies had suspected nosocomially acquired infection. As of July 28, 2020, 58 (88%) babies had been discharged home, seven (11%) were still admitted, and one (2%) had died of a cause unrelated to SARS-CoV-2 infection.
Neonatal SARS-CoV-2 infection is uncommon in babies admitted to hospital. Infection with neonatal admission following birth to a mother with perinatal SARS-CoV-2 infection was unlikely, and possible vertical transmission rare, supporting international guidance to avoid separation of mother and baby. The high proportion of babies from Black |
| doi_str_mv | 10.1016/S2352-4642(20)30342-4 |
| format | Article |
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We carried out a prospective UK population-based cohort study of babies with confirmed SARS-CoV-2 infection in the first 28 days of life who received inpatient care between March 1 and April 30, 2020. Infected babies were identified through active national surveillance via the British Paediatric Surveillance Unit, with linkage to national testing, paediatric intensive care audit, and obstetric surveillance data. Outcomes included incidence (per 10 000 livebirths) of confirmed SARS-CoV-2 infection and severe disease, proportions of babies with suspected vertically and nosocomially acquired infection, and clinical outcomes.
We identified 66 babies with confirmed SARS-CoV-2 infection (incidence 5·6 [95% CI 4·3–7·1] per 10 000 livebirths), of whom 28 (42%) had severe neonatal SARS-CoV-2 infection (incidence 2·4 [1·6–3·4] per 10 000 livebirths). 16 (24%) of these babies were born preterm. 36 (55%) babies were from white ethnic groups (SARS-CoV-2 infection incidence 4·6 [3·2–6·4] per 10 000 livebirths), 14 (21%) were from Asian ethnic groups (15·2 [8·3–25·5] per 10 000 livebirths), eight (12%) were from Black ethnic groups (18·0 [7·8–35·5] per 10 000 livebirths), and seven (11%) were from mixed or other ethnic groups (5·6 [2·2–11·5] per 10 000 livebirths). 17 (26%) babies with confirmed infection were born to mothers with known perinatal SARS-CoV-2 infection, two (3%) were considered to have possible vertically acquired infection (SARS-CoV-2-positive sample within 12 h of birth where the mother was also positive). Eight (12%) babies had suspected nosocomially acquired infection. As of July 28, 2020, 58 (88%) babies had been discharged home, seven (11%) were still admitted, and one (2%) had died of a cause unrelated to SARS-CoV-2 infection.
Neonatal SARS-CoV-2 infection is uncommon in babies admitted to hospital. Infection with neonatal admission following birth to a mother with perinatal SARS-CoV-2 infection was unlikely, and possible vertical transmission rare, supporting international guidance to avoid separation of mother and baby. The high proportion of babies from Black, Asian, or minority ethnic groups requires investigation.
UK National Institute for Health Research Policy Research Programme.</description><identifier>ISSN: 2352-4642</identifier><identifier>EISSN: 2352-4650</identifier><identifier>DOI: 10.1016/S2352-4642(20)30342-4</identifier><identifier>PMID: 33181124</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject><![CDATA[COVID-19 - diagnosis ; COVID-19 - epidemiology ; COVID-19 - transmission ; Cross Infection - epidemiology ; Cross Infection - transmission ; Cross Infection - virology ; Ethnicity - statistics & numerical data ; Female ; Hospitalization - statistics & numerical data ; Humans ; Incidence ; Infant, Newborn ; Infectious Disease Transmission, Vertical - statistics & numerical data ; Intensive Care, Neonatal - statistics & numerical data ; Male ; Obstetrics - statistics & numerical data ; Pregnancy ; Pregnancy Complications, Infectious - epidemiology ; Pregnancy Complications, Infectious - virology ; Premature Birth - epidemiology ; SARS-CoV-2 - isolation & purification ; United Kingdom - epidemiology]]></subject><ispartof>The lancet child & adolescent health, 2021-02, Vol.5 (2), p.113-121</ispartof><rights>2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license</rights><rights>Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.</rights><rights>2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c613t-b4ef3ce2faf06b0dee5983e0491a356f68ad38fc373e36b6fc1655fb183290433</citedby><cites>FETCH-LOGICAL-c613t-b4ef3ce2faf06b0dee5983e0491a356f68ad38fc373e36b6fc1655fb183290433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33181124$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gale, Chris</creatorcontrib><creatorcontrib>Quigley, Maria A</creatorcontrib><creatorcontrib>Placzek, Anna</creatorcontrib><creatorcontrib>Knight, Marian</creatorcontrib><creatorcontrib>Ladhani, Shamez</creatorcontrib><creatorcontrib>Draper, Elizabeth S</creatorcontrib><creatorcontrib>Sharkey, Don</creatorcontrib><creatorcontrib>Doherty, Cora</creatorcontrib><creatorcontrib>Mactier, Helen</creatorcontrib><creatorcontrib>Kurinczuk, Jennifer J</creatorcontrib><title>Characteristics and outcomes of neonatal SARS-CoV-2 infection in the UK: a prospective national cohort study using active surveillance</title><title>The lancet child & adolescent health</title><addtitle>Lancet Child Adolesc Health</addtitle><description>Babies differ from older children with regard to their exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, data describing the effect of SARS-CoV-2 in this group are scarce, and guidance is variable. We aimed to describe the incidence, characteristics, transmission, and outcomes of SARS-CoV-2 infection in neonates who received inpatient hospital care in the UK.
We carried out a prospective UK population-based cohort study of babies with confirmed SARS-CoV-2 infection in the first 28 days of life who received inpatient care between March 1 and April 30, 2020. Infected babies were identified through active national surveillance via the British Paediatric Surveillance Unit, with linkage to national testing, paediatric intensive care audit, and obstetric surveillance data. Outcomes included incidence (per 10 000 livebirths) of confirmed SARS-CoV-2 infection and severe disease, proportions of babies with suspected vertically and nosocomially acquired infection, and clinical outcomes.
We identified 66 babies with confirmed SARS-CoV-2 infection (incidence 5·6 [95% CI 4·3–7·1] per 10 000 livebirths), of whom 28 (42%) had severe neonatal SARS-CoV-2 infection (incidence 2·4 [1·6–3·4] per 10 000 livebirths). 16 (24%) of these babies were born preterm. 36 (55%) babies were from white ethnic groups (SARS-CoV-2 infection incidence 4·6 [3·2–6·4] per 10 000 livebirths), 14 (21%) were from Asian ethnic groups (15·2 [8·3–25·5] per 10 000 livebirths), eight (12%) were from Black ethnic groups (18·0 [7·8–35·5] per 10 000 livebirths), and seven (11%) were from mixed or other ethnic groups (5·6 [2·2–11·5] per 10 000 livebirths). 17 (26%) babies with confirmed infection were born to mothers with known perinatal SARS-CoV-2 infection, two (3%) were considered to have possible vertically acquired infection (SARS-CoV-2-positive sample within 12 h of birth where the mother was also positive). Eight (12%) babies had suspected nosocomially acquired infection. As of July 28, 2020, 58 (88%) babies had been discharged home, seven (11%) were still admitted, and one (2%) had died of a cause unrelated to SARS-CoV-2 infection.
Neonatal SARS-CoV-2 infection is uncommon in babies admitted to hospital. Infection with neonatal admission following birth to a mother with perinatal SARS-CoV-2 infection was unlikely, and possible vertical transmission rare, supporting international guidance to avoid separation of mother and baby. The high proportion of babies from Black, Asian, or minority ethnic groups requires investigation.
UK National Institute for Health Research Policy Research Programme.</description><subject>COVID-19 - diagnosis</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - transmission</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - transmission</subject><subject>Cross Infection - virology</subject><subject>Ethnicity - statistics & numerical data</subject><subject>Female</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant, Newborn</subject><subject>Infectious Disease Transmission, Vertical - statistics & numerical data</subject><subject>Intensive Care, Neonatal - statistics & numerical data</subject><subject>Male</subject><subject>Obstetrics - statistics & numerical data</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Infectious - epidemiology</subject><subject>Pregnancy Complications, Infectious - virology</subject><subject>Premature Birth - epidemiology</subject><subject>SARS-CoV-2 - isolation & purification</subject><subject>United Kingdom - epidemiology</subject><issn>2352-4642</issn><issn>2352-4650</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUctuGyEURVWjJnLyCa1YpotpeQ3GXTSKrPShRKoUJ90ihrnEVGNwgbGUH-h3F8eulay64nLPOffCOQi9peQDJVR-XDDeskZIwc4Zec8JF_X2Cp3s2y15fagFO0ZnOf8ihFCl6JSIN-iYc6ooZeIE_ZkvTTK2QPK5eJuxCT2OY7FxBRlHhwPEYIoZ8OLydtHM48-GYR8c2OJjqBUuS8D315-wwesU83oLbABXTcWrzMZlTAXnMvaPeMw-PGCzo-QxbcAPgwkWTtGRM0OGs_05Qfdfru7m35qbH1-_zy9vGispL00nwHELzBlHZEd6gHamOBAxo4a30klleq6c5VMOXHbSWSrb1nVUcTYjgvMJ-rybux67FfQWQklm0OvkVyY96mi8fokEv9QPcaOniqq2Gj1B5_sBKf4eIRe98tnC9hcQx6yZkGQqZ0LISm13VFt9yQncYQ0lehujfopRbzPSjOinGLWounfP33hQ_QutEi52BKhObTwkna2H6mLvU7Vf99H_Z8VfsEqvUg</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Gale, Chris</creator><creator>Quigley, Maria A</creator><creator>Placzek, Anna</creator><creator>Knight, Marian</creator><creator>Ladhani, Shamez</creator><creator>Draper, Elizabeth S</creator><creator>Sharkey, Don</creator><creator>Doherty, Cora</creator><creator>Mactier, Helen</creator><creator>Kurinczuk, Jennifer J</creator><general>Elsevier Ltd</general><general>The Authors. 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However, data describing the effect of SARS-CoV-2 in this group are scarce, and guidance is variable. We aimed to describe the incidence, characteristics, transmission, and outcomes of SARS-CoV-2 infection in neonates who received inpatient hospital care in the UK.
We carried out a prospective UK population-based cohort study of babies with confirmed SARS-CoV-2 infection in the first 28 days of life who received inpatient care between March 1 and April 30, 2020. Infected babies were identified through active national surveillance via the British Paediatric Surveillance Unit, with linkage to national testing, paediatric intensive care audit, and obstetric surveillance data. Outcomes included incidence (per 10 000 livebirths) of confirmed SARS-CoV-2 infection and severe disease, proportions of babies with suspected vertically and nosocomially acquired infection, and clinical outcomes.
We identified 66 babies with confirmed SARS-CoV-2 infection (incidence 5·6 [95% CI 4·3–7·1] per 10 000 livebirths), of whom 28 (42%) had severe neonatal SARS-CoV-2 infection (incidence 2·4 [1·6–3·4] per 10 000 livebirths). 16 (24%) of these babies were born preterm. 36 (55%) babies were from white ethnic groups (SARS-CoV-2 infection incidence 4·6 [3·2–6·4] per 10 000 livebirths), 14 (21%) were from Asian ethnic groups (15·2 [8·3–25·5] per 10 000 livebirths), eight (12%) were from Black ethnic groups (18·0 [7·8–35·5] per 10 000 livebirths), and seven (11%) were from mixed or other ethnic groups (5·6 [2·2–11·5] per 10 000 livebirths). 17 (26%) babies with confirmed infection were born to mothers with known perinatal SARS-CoV-2 infection, two (3%) were considered to have possible vertically acquired infection (SARS-CoV-2-positive sample within 12 h of birth where the mother was also positive). Eight (12%) babies had suspected nosocomially acquired infection. As of July 28, 2020, 58 (88%) babies had been discharged home, seven (11%) were still admitted, and one (2%) had died of a cause unrelated to SARS-CoV-2 infection.
Neonatal SARS-CoV-2 infection is uncommon in babies admitted to hospital. Infection with neonatal admission following birth to a mother with perinatal SARS-CoV-2 infection was unlikely, and possible vertical transmission rare, supporting international guidance to avoid separation of mother and baby. The high proportion of babies from Black, Asian, or minority ethnic groups requires investigation.
UK National Institute for Health Research Policy Research Programme.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>33181124</pmid><doi>10.1016/S2352-4642(20)30342-4</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | COVID-19 - diagnosis COVID-19 - epidemiology COVID-19 - transmission Cross Infection - epidemiology Cross Infection - transmission Cross Infection - virology Ethnicity - statistics & numerical data Female Hospitalization - statistics & numerical data Humans Incidence Infant, Newborn Infectious Disease Transmission, Vertical - statistics & numerical data Intensive Care, Neonatal - statistics & numerical data Male Obstetrics - statistics & numerical data Pregnancy Pregnancy Complications, Infectious - epidemiology Pregnancy Complications, Infectious - virology Premature Birth - epidemiology SARS-CoV-2 - isolation & purification United Kingdom - epidemiology |
| title | Characteristics and outcomes of neonatal SARS-CoV-2 infection in the UK: a prospective national cohort study using active surveillance |
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