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COVID-19 in neonates and infants younger than 6 months - a mild viral illness
Lana Khoury1, Giora Pillar1,2, Shereen Shehadeh3,4,5
1Department of Pediatrics, Carmel Medical Center, Haifa, Israel.
Insights
COVID-19 in infants under six months is generally mild, with most cases showing no severe complications during the Omicron wave. Hospitalization is often unnecessary for well-appearing infants receiving supportive care.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- The Omicron variant surge led to increased pediatric COVID-19 cases.
- Limited data exists on clinical features and disease course in neonates and young infants with COVID-19.
Purpose of the Study:
- To describe clinical and laboratory features of COVID-19 in infants younger than six months.
- To outline the disease course and identify potential complications in this age group.
Main Methods:
- Retrospective descriptive study.
- Data collected from electronic medical records of infants (<6 months) with positive COVID-19 nasal swabs.
- Study period: December 2021 to December 2022 (Omicron wave).
Main Results:
- Fifty-two infants tested positive for COVID-19.
- 21% discharged from ER; others hospitalized for observation/supportive treatment (average 1.3 days).
- No major complications were observed in the studied infants.
Conclusions:
- COVID-19 presents as a mild viral illness in young infants.
- Most infants experienced no major complications.
- Hospitalization may not be required for well-appearing infants if clinical and lab evaluations are reassuring.
Abstract:
A surge in pediatric COVID-19 cases was observed during the fifth wave (Omicron) of the COVID-19 pandemic. Little is known about the clinical features and disease course in neonates and young infants. To describe the clinical and laboratory features, disease course and complications of COVID-19 in neonates and infants younger than 6 months. A retrospective descriptive study in which data were collected from the electronic medical records of infants younger than 6 months, with positive nasal swab tests for COVID-19. Fifty-two infants younger than 6 months who tested positive for COVID-19 were admitted to our pediatric ER/department during the omicron wave of the COVID-19 pandemic, between December 2021 and December 2022. Twenty-one percent were discharged from the ER, while the others were hospitalized predominantly for observation or supportive treatment, with an average duration of hospitalization of 1.3 ± 0.7 days. No major complications were observed. Conclusion: COVID-19 is a mild viral illness in young healthy infants with no major complications. What is Known: • Pediatric patients generally have a milder clinical presentation of COVID-19 but can also experience more severe symptoms and post-COVID phenomena. • Our knowledge of COVID-19 in neonates and young infants is limited, and guidelines for their diagnosis and management are lacking. What is New: • In neonates and young infants, COVID-19 infection is typically a mild viral illness with no major complications observed in the majority of cases. • Hospitalization may not be necessary for well-appearing infants with COVID-19, as long as their clinical and laboratory evaluations do not raise any concerns.
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