COVID-19 and infants: clinic, diagnosis and treatment tactics (literature review)

New insights are being continuously accumulated regarding the etiopathogenesis and clinical characteristics of COVID-19 across various age groups, with tactical approaches to its prophylaxis and treatment based on principles of evidence-based medicine. This article presents a comprehensive literature review addressing the transmission mechanisms, clinical manifestations, diagnostic criteria, treatment tactics, preventive measures, and outcomes of COVID-19 in neonates and infants. The discussion highlights conflicting evidence from both domestic and international research, which contrasts the potential risk against the absence of vertical transmission of SARS-CoV-2 from infected mothers. It also examines isolated risks associated with breastfeeding during maternal infection. The reported risk for perinatal transmission of SARS-CoV-2 has been found to range between 3.2% (2021) and 23.4% (2020). The clinical presentation of COVID-19 in infants is typically nonspecific, with a predominance of asymptomatic or mild disease forms (noted in 20–76% of cases). However, premature infants have been shown to exhibit higher incidences of intoxication syndrome and gastrointestinal and respiratory symptoms. Severe disease cases, including critical forms of COVID-19 accompanied by progressive multisystem inflammatory syndrome, have been described in 6–12% of affected infants. Numerous studies have demonstrated the efficacy and safety of utilizing recombinant interferon alpha-2b in combination with antioxidants (including vitamins Е and C) for the treatment and prevention of COVID-19 in term neonates and preterm infants. These therapeutic protocols have been associated with reductions in SARS-CoV-2 viral shedding time, decreased mortality rates, and lower risk of infection among close contacts of infected infants KEYWORDS: new coronavirus infection, COVID-19, perinatal contact, infants, interferon alpha-2b, Viferon. FOR CITATION: Panova L.D., Khismatullina Z.R., Gurova Z.G., Panov P.V., Galeeva A.A., Hammatshina A.R., Idrisova A.F. COVID-19 and infants: clinic, diagnosis and treatment tactics (literature review). Russian Journal of Woman and Child Health. 2025;8(2):156–165 (in Russ.). DOI: 10.32364/2618-8430-2025-8-2-11