Clinical and Laboratory Results of Newborn Babies Born from Pregnant Women Infected with COVID-19

Abstract

Aim: Covidien-19, which is a worldwide pandemic virus, has caused numerous casualties. Studies are carried out on newborn babies of pregnant women infected with the new type of coronavirus, and studies are in progress investigating vertical transmission. In our study, we plan to evaluate the clinical and laboratory results of newborn babies born from pregnant women infected with COVID-19 y. Materials and Method: This retrospective cohort study was carried out at Medical Sciences University Konya Teaching and Research Hospital, between April 2020 and August 2020. Newborn babies born from pregnant women, who were found to have a new type of coronavirus (SARS-CoV-2) infection with reverse transcriptase-polymerase chain reaction (RT-PCR) at the time of delivery, were included in the study. Complete blood count, biochemical profile, acute phase reactants, D-Dimer and ferritin values of pregnant women while they were infected with the SARS-CoV-2 were recorded. Complete blood count, biochemical values and acute phase reactants of newborn babies as well as two COVID-RT-PCR test results, conducted 24-hours apart, were noted. Fourteen pregnant women and their newborns, who satisfy the requirements, were included in the study. Results: Fourteen mothers and babies were included in the study. Both COVID-RT-PCR results of all newborn babies came back negative. Lymphocyte percentage and values of newborns were statistically higher compared to their mothers (p<0.05). At the time of hospitalization, the most common symptom was respiratory distress with 7 (50%) patients. Looking at the diagnosis at the time of hospitalizations, 6 (42.9%) patients had transient tachypnea of neonates, 1 (7.1%) had early onset neonatal sepsis and 1 (7.1%) had hypoxic ischemic encephalopathy. Six healthy babies were hospitalized in the NICU due to their mothers’ condition. In addition, the patient, who was followed up with a diagnosis of hypoxic ischemic encephalopathy, died due to her primary disease. Conclusion: In our study, we observed the absence of transplacental transmission from pregnant women infected with SARS-CoV-2 to their newborn babies.

Keywords

• COVID-19
• newborn
• pregnant women
• vertical
• transplacental

Covid 19 Testi Pozitif iken Doğum Yapan 14 Gebenin Bebeklerinin Klinik ve Laboratuvar Sonuçları

Abstract

Amaç: Dünya çapında bir pandemiye neden olan COVID-19 virüsü çok sayıda can kaybına neden olmuştur. Yeni tip koronavirüs ile enfekte olan gebelerin yenidoğan bebekleri ile ilgili çalışmalar yapılmakta olup vertikal geçiş açısından çalışmalar devam etmektedir. Biz de çalışmamızda COVID-19 ile enfekte olan gebelerden doğan yenidoğan bebeklerin klinik ve laboratuvar sonuçlarını değerlendirmeyi planladık. Gereçler ve Yöntem: Bu retrospektif çalışma, Sağlık Bilimleri Üniversitesi Konya Eğitim ve Araştırma Hastanesi Yenidoğan Yoğun Bakım Ünitesinde Nisan 2020- Ağustos 2020 tarihleri arasında yapıldı. Doğum yaptığı esnada revers transkriptaz-polimeraz zincir reaksiyonu (RT-PCR) ile yeni tip koronavirüs (SARS-CoV-2) enfeksiyonu saptanan gebelerden doğan yenidoğan bebeklerin çalışmaya dahil edilmesi planlandı. Gebelerin SARS-CoV-2 ile enfekte olduğu dönemde bakılan tam kan sayımı, biyokimyasal değerleri, akut faz reaktanları, D-Dimer ve ferritin değerleri kaydedildi. Yenidoğan bebeklerde ise tam kan sayımı, biyokimyasal değerleri ve akut faz reaktanları değerlendirilmeye alındı. Yenidoğan bebeklerin hepsinde 24 saat ile bakılan 2 tane COVID RT-PCR sonuçları not edildi. Gereken verilerine ulaşılan 14 gebe ve yenidoğan bebeği çalışmaya dahil edildi. Bulgular: Yenidoğan bebeklerin hepsinde 24 saat ara ile bakılan 2 tane COVID RT-PCR sonucu negatif olarak geldi. Yenidoğanların lenfosit yüzdesi ve değeri annelerine göre istatistiksel olarak yüksek saptandı (p<0,05). Yatış anındaki şikayetler değerlendirildiğinde; en sık şikayet 7 hastada (%50,0) solunum sıkıntısı idi. Yatış tanılarına bakıldığında; 6 hasta (%42,9) sağlıklı bebek, 6 hasta(%42,9) yenidoğan geçici takipnesi, 1 hasta (%7,1) erken neonatal sepsis ve 1 hasta (%7,1) hipoksik iskemik ensefalopati tanısı ile takip edildi. Ayrıca hipoksik iskemik ensefalopati tanısı ile takip edilen hasta primer hastalığı nedeni ile kaybedildi. Sonuç: Biz çalışmamızda SARS-CoV-2 ile enfekte olan gebeden yenidoğan bebeğe transplasental geçişin olmadığını destekler sonuçlar elde ettik.

Keywords

• COVID-19
• yenidoğan
• gebe
• transplasental
• vertikal

References

1. 1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, A novel coronavirus from patients with pneumonia in China. N Engl J Med 2020 Jan 24. Available from: https://www.nejm.org/doi/10.1056/ NEJMoa2001017.
2. 2. Madabhavi I, Sarkar M, Kadakol N, COVID-19: a review. Monaldi Arch Chest Dis 2020; 90(2).
3. 3. Pascarella G, Strumia A, Piliego C, Bruno F, Del Buono R, Costa F, et al, COVID-19 diagnosis and management: a comprehensive review. J Intern Med 2020; 288(2): 192-206.
4. 4. Singhal T, A Review of Coronavirus Disease-2019 (COVID-19). Indian J Pediatr 2020; 87(4): 281-286.
5. 5. Hoffmann M, Kleine-Weber H, Krügir N, Müller M, Drosten C, Pöhlmann S, The novel coronavirus 2019 (2019-nCov) uses the SARS-coronavirus receptor 2 ACE2 and the cellular protease TMPRSS2 for entry into target cells. BioRxiv 2020. Available from: https://doi.org/10.1101/2020. 01.31.929042.
6. 6. Ovalı F, COVID-19 Infections in Newborns. Anadolu Kliniği Tıp Bilimleri Dergisi Ocak 2020; Cilt 25, Özel Sayı 1.
7. 7. Dhochak N, Singhal T, Kabra SK, Lodha R, Pathophysiology of COVID-19: Why Children Fare Better than Adults? Indian J Pediatr 2020; 87(7): 537-546.
8. 8. Outpatient Assessment and Management for Pregnant Women With Suspected or Confirmed Novel Coronavirus (COVID-19). 2020 April 24, 2020. Available from: https://www.acog.org//media/project/acog/acogorg/files/pdfs/clinicalguidance/practiceadvisory/covid-19-algorithm.pdf.

9. 9. Uygur Ö, Öncel MY, Perinatal ve yenidoğan döneminde Covid-19 enfeksiyonu. Tepecik Eğit ve Araşt Hast Dergisi 2020;30(Ek sayı):63-9.
10. 10. Oncel MY, Akın IM, Kanburoglu M, Tayman C, Coskun S, Narter F, Neo-Covid Study Group, A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society. Eur J Pediatr 2020;1-10.
11. 11. Schwartz DA, An Analysis of 38 Pregnant Women with COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes. Arch Pathol Lab Med 2020 Mar 17.
12. 12. Yang P, Wang X, Liu P, Wei C, He B, Zheng J, et al, Clinical characteristics and risk assessment of newborns born to mothers with COVID-19. J Clin Virol 2020;127:104356.
13. 13. Hermansen CL, Lorah KN, Respiratory distress in the newborn. Am Fam Physician 2007;76(7):987-94.
14. 14. Kurl S, Heinonen KM, Kiekara O, The first chest radiograph in neonates exhibiting respiratory distress at birth. Clin Pediatr (Phila) 1997;36(5):285-9.
15. 15. Chen Y, Peng H, Wang L, Zhao Y, Zeng L, Gao H, et al, Infants Born to Mothers With a New Coronavirus (COVID-19). Front Pediatr 2020;8:104.
16. 16. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al, Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020;395(10226):809-815.
17. 17. Mullins E, Evans D, Viner RM, O'Brien P, Morris E, Coronavirus in pregnancy and delivery: rapid review. Ultrasound Obstet Gynecol 2020(e-pub ahead of print).
18. 18. Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M, et al, Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2020;2(2):100107.
19. 19. Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, et al, Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr 2020;9(1):51-60.
20. 20. Zaigham M, Andersson O, Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand 2020; 99(7):823-829.
21. 21. Sun M, Xu G, Yang Y, Tao Y, Pian-Smith M, Madhavan V, et al, Evidence of mother-to-newborn infection with COVID-19. Br J Anaesth 2020;125(2):e245-e247.
22. 22. Liu W, Wang J, Li W, Zhou Z, Liu S, Rong Z, Clinical characteristics of 19 neonates born to mothers with COVID-19. Front Med 2020;14(2):193-198.
23. 23. Vivanti AJ, Vauloup-Fellous C, Prevot S, Zupan V, Suffee C, Do Cao J, et al, Transp-lacental transmission of SARS-CoV-2 infection. Nat Commun 2020;11(1):3572.
24. 24. Ryan GA, Purandare NC, McAuliffe FM, Hod M, Purandare CN, Clini-cal update on COVID-19 in pregnancy: A review article. J Obstet Gynaecol Res 2020;46(8):1235-1245.
25. 25. Yan J, Guo J, Fan C, Juan J, Yu X, Li J, et al, Coronavirus disease 2019 (COVID-19) in pregnancy women: A report based on 116 cases. Am J Obstet Gynecol 2020; 223(1):111.e1-111.e14.
26. 26. Hantoushzadeh S, Shamshirsaz AA, Aleyasin A, Seferovic MD, Aski SK, Arian AE, et al, Maternal death due to COVID‐19 disease. Am J Obstet Gynecol 2020: S0002‐9378(20)30516‐0 10.1016/j.ajog.2020.04.030.
27. 27. Li N, Han L, Peng M, Lv Y, Ouyang Y, Liu K, et al, Maternal and Neonatal Outco-mes of Pregnant Women With Coronavirus Disease 2019 (COVID-19) Pneumonia: A Case-Control Study. Clin Infect Dis 2020;71(16):2035-2041.
28. 28. Vakili S, Savardashtaki A, Jamalnia S, Tabrizi R, Nematollahi MH, Jafarinia M, et al, Laboratory Findings of COVID-19 Infection are Conflicting in Different Age Groups and Pregnant Women: A Literature Review. Arch Med Res 2020; 51(7): 603–607.