Clinical Characteristics and Outcomes of Neonates with Proven COVID-19 Infection: A Tertiary Centre Experience

Background Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) affects a wide range of age groups from neonates to adults. There is wide variation in the clinical presentation of the neonates. Methods All COVID-19-positive neonates as detected by reverse transcription polymerase chain reaction (RT-PCR) in the first and second wave of the COVID-19 pandemic between June 2020 and December 2021 were included in the study. The method and timing of testing were based on national guidelines. Antenatal history, neonatal demographic and baseline characteristics, clinical course, laboratory investigations and outcome data were noted. The data was analysed by standard statistical methods. Results A total of 31 neonates were included in the study. The most common presenting complaints at admission were respiratory distress (80%), lethargy (64%), refusal of feeds (54%) and weak crying (45%). Nearly 80% of neonates required oxygen at admission and 30% required mechanical ventilation. Four neonates (13%) died due to COVID-19. Elevated D-dimer values, low platelet count and elevated Serum Glutamic Pyruvic Transaminase (SGPT) levels were significant predictors for in-hospital mortality among neonates with COVID-19 infection. Conclusion Symptomatic COVID-19-positive neonates referred to a tertiary care centre have a protracted clinical course. The presence of thrombocytopenia, elevated liver enzymes and D-dimer is associated with poor clinical outcomes in these babies.