covid-19 negative neonates despite having an index case positive in family

Background: covid-19 is a novel virus, and research on its infectivity and pathogenesis in neonates is ongoing. objectives: we aimed to introduce a population of neonates who displayed signs and symptoms of infection but tested negative for covid-19 by pcr, despite having direct exposure to the virus within their families, as confirmed by pcr testing. methods: we conducted an observational cross-sectional study in the nicu and neonatal ward of the children's medical center hospital in tehran, iran, between august 2020 and 2021. results: we included a total of 11 neonates in this study. these neonates presented with symptoms of viral infection but had negative pcr results. the mean onset of symptoms in our patients was 2.73 days, with a minimum of 1 day and a maximum of 5 days. discussion: the possibility of false negatives in pcr testing could be attributed to testing during the early stages of infection when the viral load is low. as parents are understandably worried about their baby's risk of covid-19 infection, they bring their infants to the hospital promptly at the onset of symptoms. therefore, additional and delayed tests may be required to improve the accuracy of detecting newborn infections. conclusions: despite the small sample size and lack of testing for other viruses, our findings highlight the importance of considering false-negative pcr results in neonates with covid-19 exposure.