1 - Unidade de Infecciologia Pediátrica, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, EPE
2 - Departamento da Saúde da Mulher e da Criança, Serviço de Pediatria do Hospital do Espírito Santo de Évora, EPE
- 39th ESPID Meeting 2021, publicação sob forma de poster digital.
Resumo:
BACKGROUND: Severe acute respiratory syndrome coronavirus 2 disease (COVID19) in children presents as a mild disease compared with adults. Small infants are the exception with higher severity and worst outcomes.
METHODS: Prospective cohort study of infants under four months who, from march to december 2020, were admitted to the infecciology ward for COVID-19. The infection was confirmed through SARS CoV 2 PCR in naso/ oropharyngeal swabs or respiratory specimens.
RESULTS: We identified 35 infants with a median age of 44 days. Twenty-seven (80%) had known exposure to a SARS-CoV-2 infected person, five in the hospital setting. Eight had comorbidities: prematurity (3), bronchopulmonary dysplasia (3); congenital malformative syndrome (2), chronic kidney disease (1), short bowel syndrome (1), ventricular septal defect (1) and multifocal lymphangioendotheliomatosis (1). Most were symptomatic (86%) with fever (22), nasal congestion/ discharge (16), cough (14), feeding (14) and breathing difficulties (10) being the most common symptoms. Over the course of the disease, we verified neutropenia (15) and lymphopenia (4); Elevated C-reactive protein (6), ferritin (11), procalcitonin (9) and D-dimers (18). Two had respiratory viral co-infections. The chest radiography was altered in 15. Three had severe disease and received supplemental oxygen and 3 critical disease and needed invasive mechanical ventilation and ICU support. Five received lopinavir/ritonavir, two remdesivir and one hydroxychloroquine. Three received corticosteroids, eleven antibiotic therapy and two prophylactic oseltamivir. The average admission time was 7 days and there was one death. Two infants had sustained oxygen needs after discharge.
CONCLUSIONS: COVID19 in the newborn and small infant presents as an upper respiratory tract infection with fever. The severity of the disease is non-negligible with a considerable proportion of severe and critical cases. Underlying comorbidities seem possible drivers of disease severity.
Palavras Chave: COVID19, INFANTS, NEONATES