Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can occur in
neonates as the virus can be transmitted both horizontally (from the environment)
and vertically (during the pregnancy or at the delivery). Compared to the adult outbreak,
neonatal infections do not represent a public health problem. Nonetheless, severe
and life-threatening cases may rarely occur and both obstetricians and neonatologists
should have a good knowledge of perinatal SARS-CoV-2 infection and related consequences.
A high suspicion index must be applied and ruling out neonatal SARS-CoV-2 infection
must become a part of the routine clinical workout. Moreover, neonates may be affected
by the multisystem inflammatory syndrome, due to a dysregulated host response in the
absence of any SARS-CoV-2 infection. We performed a narrative review to summarize
here the available literature describing the essentials that should be known by every
neonatologist and obstetrician, starting from what has been discovered in 2020 and
adding what has been learned in the following years. The paper describes the mechanisms
of transmission, clinical features, diagnostic tools, and criteria, as well as possible
treatment and prevention strategies. The goal is to provide the practical points to
be remembered at the bedside while caring for a pregnant woman or a neonate with suspected
or proven coronavirus disease 2019 or multisystem inflammatory syndrome.
Key Points
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SARS-CoV-2 neonatal infections occur both vertically (30%) and horizontally (70%).
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Approximately, half of patients do not have clinical manifestations; clinical and
laboratory signs are similar to those of adults but usually milder.
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Remdesivir and steroids can be used as a treatment.
Keywords
coronavirus - neonate - pregnancy - treatment - COVID-19