clinical findings, laboratory assessment, and outcomes of 44 infants born to mothers with confirmed or suspected covid-19: a multicenter cohort study

Background: coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (sars-cov-2) has spread worldwide, causing a significant public health disaster. objectives: the present study aimed to evaluate the clinical features and laboratory data of neonates born to mothers with covid-19. methods: a retrospective multicenter cohort study was conducted from march 20 to september 5, 2020, on all neonates born to mothers with positive real-time reverse transcriptase-polymerase chain reaction for sars-cov-2 or clinically suspected covid-19. neonates enrolled in this study were from five different hospitals affiliated with the tehran university of medical sciences. all the newborns were tested for sars-cov-2 using nasopharyngeal swabs during the first 24 - 48 hours of life, and a second-time swabbing was performed as indicated at subsequent visits. all categorical data were manifested as frequency (%), and continuous data were shown as mean±sd. results: forty-four neonates born to 39 infected mothers were evaluated during the study period. nineteen women had complications during pregnancy, including hypertensive disorders, gestational diabetes, preterm labor, etc. besides, 54.5% of the neonates were born preterm. the mean gestational age and birth weight were 35.11 ± 4.01 weeks and 2,567 ± 898 g, respectively. fifteen (34.1%) neonates were symptomatic at birth, and during the observation, more neonates became symptomatic. finally, 27/44 (61.3%) neonates became symptomatic, and 17/44 remained asymptomatic. the most common clinical manifestations were respiratory distress (77.7%), followed by fever or hypothermia (18.5%), gastrointestinal problems (14.8%), and neurologic findings (3.7%). also, the most common clinical feature of eight neonates with positive rt-pcr was respiratory distress, followed by neurologic symptoms, temperature instability, and gastrointestinal disorder, in sequence. few abnormalities were seen in laboratory findings. chest xrays were abnormal in 22.2% of the neonates. conclusions: the sars-cov-2 infection during pregnancy may cause severe maternal and neonatal morbidities. neonates with positive sars-cov-2 may demonstrate a spectrum of clinical features. the most common feature of neonates born to mothers with covid-19 was respiratory distress.