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COVID-19 infections in infants
Małgorzata Sobolewska-Pilarczyk1, Maria Pokorska-Śpiewak2,3, Anna Stachowiak4
1Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
Insights
COVID-19 in infants often presents as mild gastrointestinal or respiratory illness, but can include pneumonia. Hospitalizations increased significantly during the second pandemic wave, with younger infants affected.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- COVID-19 affects infants, with varying clinical presentations.
- Understanding infant SARS-CoV-2 infection is crucial for public health.
- The pandemic's waves may have influenced disease patterns in infants.
Purpose of the Study:
- To analyze the clinical course of COVID-19 in a cohort of 300 infants.
- To compare COVID-19 presentation and hospitalization rates between pandemic waves.
- To identify key symptoms and risk factors for severe disease in infants.
Main Methods:
- Retrospective analysis of 300 infants diagnosed with COVID-19 from the SARSTerPED multicenter database (March-December 2020).
- Data collected included demographics, symptoms, diagnoses (pneumonia, gastrointestinal), and laboratory markers (D-dimers, IL-6).
- Comparison of clinical data between the first and second waves of the pandemic.
Main Results:
- Common symptoms included fever (77%), cough (40%), and catarrh (37%).
- 23% of infants had pneumonia, and 31.3% experienced gastrointestinal symptoms.
- Hospitalization rates were 6 times higher in the second wave, with younger infants hospitalized longer.
Conclusions:
- COVID-19 in infants typically presents as mild gastrointestinal or respiratory infection, but pneumonia can occur.
- Infants may contribute to household SARS-CoV-2 transmission, even with mild symptoms.
- Gastrointestinal symptoms and appetite loss in infants warrant COVID-19 testing and can necessitate hospitalization.
Abstract:
The study aimed to analyse the clinical course of COVID-19 in 300 infants, selected from 1283 children diagnosed with COVID-19 between March and December 2020, registered in the SARSTerPED multicenter database. Most of the infants were registered in October and November 2020. 44% of the group were girls, and 56% were boys. At diagnosis, the most common symptoms were fever in 77% of the children, cough in 40%, catarrh in 37%. Pneumonia associated with COVID-19 was diagnosed in 23% of the children, and gastrointestinal symptoms in 31.3%. In 52% of the infants, elevated levels of D-dimers were observed, and in 40%, elevated levels of IL-6 serum concentration were observed. During the second wave of the pandemic, 6 times more infants were hospitalized, and the children were statistically significantly younger compared to the patients during the first wave (3 months vs 8 months, p < 0.0001 respectively). During the second wave, the infants were hospitalized for longer. COVID-19 in infants usually manifests as a mild gastrointestinal or respiratory infection, but pneumonia is also observed with falls in oxygen saturation, requiring oxygen therapy. Gastrointestinal symptoms are common in infants infected with SARS-CoV-2, and infant appetite disorders may lead to hospitalization. The clinical course of the disease differed significantly between the first and second wave of the pandemic. It seems that infants may play a role in the transmission of SARS-COV-2 infections in households, despite mild or asymptomatic courses; eating disorders in infants should be an indication for COVID-19 testing.
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