1 - Unidade Infecciologia, Área Pediatria Médica, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
- Apresentado como poster em 40th Annual Meeting of the European Society of Paediatric Infectious Diseases
BACKGROUND: Although data suggest that COVID19 is generally milder in children under 4 months, factors that influence complications and poor prognosis are not fully understood.
METHODS: Retrospective cohort study in infants under 4 months admitted with COVID-19 or SARS-CoV-2 infection, from March 2020 to December 2021. All children had SARS-CoV-2 PCR in naso/oropharyngeal swabs or respiratory specimens. Demographic, clinic, laboratorial, imaging and evolution data was collected. P-value < .05 was considered as statistically significant.
RESULTS: We identified 72 patients with median age of 38 days, 33% were newborns and 58% males. Comorbidities were present in 14 patients, including prematurity (n=8) and congenital malformations (n=4). Also, 82% had family members infected with COVID-19. Fever (69%) and upper respiratory tract symptoms (74%) were the most common symptoms identified. When compared with newborns, fever was more frequently reported in small infants (p-value .016) as well as upper respiratory tract symptoms (p-value .049). Mild-moderate cases were 79%, severe 17% and critical 4%, with one death reported in this last group. In the severe-critical group, the majority of patients (80%) had either comorbidities or another viral co-infection (p- value <.001) and only 27% were newborns. We followed 40 patients on outpatient care and 27 out of 31 (87%) had SARS-CoV-2 antibodies. Additionally, no sequelae associated to COVID19 have been described during follow-up.
CONCLUSION: COVID-19 in infants under 4 months is usually mild to moderate, although 21% presented a severe-critical course. Poor prognosis was associated with comorbidities or co-infection. Despite the young age, the majority of our patients fully recovered and developed immunity. More studies are needed to assess the future effects of this infection.
Palavras Chave: COVID-19, pequeno lactente, recém-nascido