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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Long-Term Growth and Neurodevelopmental Outcomes of Neonates Infected with SARS-CoV-2 during the COVID-19 Pandemic at
Medha Goyal1, Dwayne Mascarenhas2, Prashanth Rr3
1Division of Neonatology, McMaster Children's Hospital, Hamilton, Ontario, Canada.
Insights
Neonates infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) face increased risks of developmental delays. This study found mild delays in expressive language, fine motor, and receptive language skills by 18-24 months of age.
Area of Science:
- Neonatal development
- Infectious diseases
- Neurology
Background:
- Early concerns regarding severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) neuroinvasion and long-term neurological effects.
- Limited data exists on the long-term developmental outcomes for neonates diagnosed with COVID-19.
Purpose of the Study:
- To assess the neurodevelopmental outcomes in neonates infected with SARS-CoV-2.
- To evaluate growth, hearing, and vision in this cohort at 18-24 months corrected age.
Main Methods:
- Prospective study of 20 neonates with SARS-CoV-2 infection during the first pandemic wave (April-July 2020).
- Neurodevelopmental assessment using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) at 18-24 months corrected age.
- Included evaluations for growth, hearing, and vision.
Main Results:
- Nearly half (45%) of the neonates exhibited mild developmental delays in motor, cognitive, or language domains.
- Moderate delays (10%) were observed in some cases, predominantly affecting expressive language, fine motor skills, and receptive language.
- No significant hearing impairment, blindness, or growth faltering was noted. Neurodevelopmental delays were associated with significantly lower composite scores in cognitive, language, and motor domains.
Conclusions:
- Neonates infected with SARS-CoV-2 demonstrate an elevated risk for developmental delays.
- Delays are primarily observed in expressive language, fine motor, and receptive language skills by 18-24 months of age.
- The majority of identified delays are mild in severity.
Introduction:
During the early coronavirus disease (COVID-19) pandemic in 2020, researchers cautioned about the potential neuroinvasive capability of the virus and long-term neurological consequences. Although a few preliminary studies have found delayed communication, fine motor, and problem-solving skills in infants after COVID-19 infection, there continues to be a paucity of data on long-term development of neonates diagnosed with COVID-19.
Methods:
We conducted a prospective study of 20 neonates who acquired severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during the first wave of the pandemic (April-July 2020). At 18-24 months corrected age, we assessed neurodevelopment by Bayley Scales of Infant and Toddler Development, the third edition (BSID-III), along with growth, hearing, and vision evaluation.
Results:
The mean corrected age at assessment was 21 months 11 days ± 1 month 28 days. We found developmental delay in nearly half of the children with scores below one standard deviation in either of the BSID-III domains. Mild delay in either motor, cognitive, or language domains was found in 9 (45%) children and moderate delay in 2 (10%). Expressive language, fine motor, and receptive language were predominantly affected. None of the children had hearing impairment, blindness, or significant growth faltering including clinically severe microcephaly. The mean composite cognitive, language, and motor scores were significantly lower in those with neurodevelopmental delay (p value - 0.02, 0.000, and 0.03, respectively) without any differences in their disease characteristics.
Conclusion:
Neonates infected with SARS-CoV-2 have an increased risk of developmental delays in expressive language, fine motor, and receptive language skills at 18-24 months of age. The severity of delays is predominantly mild.
