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Updated: Aug 26, 2025

A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
COVID-19 and Serious Bacterial Infection in Febrile Infants Less Than 60 Days Old.
David Guernsey1, Matthew Pfeffer1, James Kimpo1
1Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York.
Febrile infants under 60 days old with COVID-19 had a significantly lower rate of serious bacterial infections (SBI) compared to those without the virus. This finding suggests SARS-CoV-2 status can aid in risk-stratifying young children for infections like UTI and bacteremia.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- The COVID-19 pandemic created uncertainty regarding SARS-CoV-2 impact on children.
- Febrile infants under 60 days old present a challenge for diagnosing serious bacterial infections (SBI).
- Existing data on SARS-CoV-2 and SBI in infants was unclear.
Purpose of the Study:
- To investigate the association between SARS-CoV-2 infection and SBI rates in febrile infants.
- To determine if COVID-19 status can be used to risk-stratify febrile infants for SBI.
- To compare SBI rates in SARS-CoV-2 positive versus negative infants.
Main Methods:
- Retrospective chart review and age-matched case-control study (March 2020-June 2021).
- Inclusion of febrile infants less than 60 days old, grouped by SARS-CoV-2 status.
- Diagnosis of SBI using blood, urine, and cerebrospinal fluid cultures.
Main Results:
- 164 infants analyzed: 30 COVID-19 positive, 134 COVID-19 negative.
- Significantly lower SBI rate in COVID-19 positive infants (0%) vs. negative (17.9%) (p=0.008).
- Statistical significance found for any SBI (p<0.001), UTI (p<0.001), and bacteremia (p<0.001) in age-matched analysis.
Conclusions:
- SARS-CoV-2 infection status is a useful factor in risk-stratifying febrile infants.
- Findings may help reduce invasive testing and antibiotic exposure in this age group.
- Low incidence of bacteremia and meningitis in infants warrants further research.
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