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Review
. 2021 Apr;180(4):1009-1031.
doi: 10.1007/s00431-020-03866-3. Epub 2020 Nov 12.

Perinatal COVID-19: review of current evidence and practical approach towards prevention and management

Venkateshwarlu Vardhelli  1 , Aakash Pandita  2 , Anish Pillai  3 , Susanta Kumar Badatya  4
Affiliations
Review

Perinatal COVID-19: review of current evidence and practical approach towards prevention and management

Venkateshwarlu Vardhelli et al. Eur J Pediatr. 2021 Apr.

Abstract

The clinical spectrum of the perinatal COVID-19 and prospective data on neonatal outcomes remains largely unexplored. Most of the existing literature is in the form of case series or single-centre experience. In this review, we aim to summarize available literature on the clinical spectrum of COVID-19 in neonates and mothers and suggest a practical approach towards management of clinical scenarios. This review explores the clinical characteristics and outcomes of COVID-19 in neonates born to mothers who were detected with the virus during the pregnancy. We conducted a comprehensive search of PubMed, Google Scholar and Cochrane Database of Systematic Review between November 2019 and June 2020 and screened articles related to perinatal COVID-19. This review included 786 mothers, among which 64% (504) were delivered by caesarian section. There were 3 still births and 107 (14%) were delivered preterm. Out of 793 neonates born, 629 neonates (79%) were tested after birth. The commonest symptom in neonates was respiratory distress. Respiratory support was needed in 60 neonates (7.6%), with 14 babies needing mechanical ventilation (1.8%), 25 needing non-invasive ventilation and 21 needing nasal oxygen. Only 35 of the 629 tested neonates (5.5%) were positive for COVID-19. Of the 35 positive neonates, 14 (40%) were symptomatic. The COVID-19 seems to have favourable neonatal outcomes. Majority of neonates are asymptomatic. Respiratory distress is the most common manifestation. What is known: •COVID-19 affects all ages. •Neonatal disease is usually mild. What is new: •Vertical transmission is a possible route of infection in neonates. •Breast milk and skin-to-skin contact are safe in COVID-19-infected mothers if performed with appropriate use of precautions such as hand and breast hygiene and masking.

Keywords: COVID-19; Neonatal Sepsis; Perinatal COVID; SARS-COV-2.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Common neonatal symptoms of COVID-19
Fig. 2
Fig. 2
Common tests available for coronavirus family
See this image and copyright information in PMC

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