BACKGROUND AND PURPOSE:

• Panetta et al. (JAMA Network Open, 2020) described the clinical manifestations and disease severity of COVID-19 in infants

METHODS:

• Case series (February 14 and May 31, 2020)
• Setting
  • Hospital in Montreal
• Participants
  • All infants (<1 year old) with PCR confirmed COVID-19
• Study design
  • Clinical features and severity of disease were compared with additional analysis based on age

RESULTS:

• 1165 infants were tested | 2% (n=25) were SARS-CoV-2 positive
  • Required hospitalization: 32% (8 of 25 positive infants)
  • Two additional infants with SARS-CoV-2 positive results were transferred to the study hospital and included in analysis
• Infant characteristics
  • 56% male
  • Median (IQR) age: 89 (34 to 193) days
  • 26% had comorbid conditions

Clinical Findings

• Mild disease was most common: 89% of cases
• Most common symptoms
  • GI tract symptoms: 85%
  • Fever: 81%
  • Upper respiratory tract symptoms: 59%
• There were no significant differences in clinical manifestation between older (3 to 12 months) and younger infants (<3 months)

Comorbid Conditions

• There was a higher incidence of comorbid conditions among older vs younger infants (P = 0.03)
  • Older infants: 46%
  • Younger infants: 7%
• Comorbid conditions included
  • Lower birth weight
  • Lower gestational age at birth
  • 5 infants (19%) had a concurrent urinary tract infection

Clinical Course and Lab Findings

• 3 of the hospitalizations were non-SARS-CoV-2 related (urinary tract infection and intussusception)
• Most hospitalized infants had mild disease: 70%
• None of the infants required supplemental oxygen
• There was one ICU admission that was unrelated to COVID-19

CONCLUSION:

• Among infants, the most common symptoms in infants with COVID-19 were GI symptoms, fever, and upper respiratory symptoms
  • GI symptoms, unlike older children and adults, were predominant even if fever was not present
• SARS-CoV-2 infection in infants was generally mild and no infants required supplemental oxygen
• The percentage of infants hospitalized with SARS-CoV-2 infection was lower than that reported by the US CDC, which the author hypothesize may reflect

…the early phase of the pandemic, when in the absence of data, infants may have been hospitalized out of an abundance of caution

These results suggest that no additional SARS-CoV-2–related investigations may be necessary for the majority of infants 

Learn More – Primary Sources:

Clinical Characteristics and Disease Severity Among Infants With SARS-CoV-2 Infection in Montreal, Quebec, Canada

Related ObG Topics:

COVID-19 Case Series: Pregnancy and Infant Outcomes

Infants Born to Mothers with COVID-19 Have Detectable Levels of Antibodies

COVID-19 in Newborns: What are the Clinical Features and Outcomes?