The Clinical Features and Outcomes of Four Neonates Born to Mothers with a Severe Form of COVID-19 and a Positive RT-PCR for SARS Co-V2 in Douala Gynaeco-Obstetric and Pediatric Hospital in Cameroon

Background: A novel viral respiratory disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for a worldwide pandemic. The effects of this new disease in pregnant women and newborns are actually not well known. Methods: We investigated the clinical features and outcomes of four neonates born to mothers with a severe form of COVID-19 and a positive RT-PCR for SARS Co-V2 in Douala Gynaeco-Obstetric and Pediatric Hospital (Cameroon) from April 20 to June 5, 2020. Results: All four mothers were symptomatic and had a positive RT-PCR for SARS CoV-2 from nasopharyngeal swab on admission. All of them delivered prematurely through cesarean section because of severe respiratory distress and one died shortly after delivery. The four premature male infants were born between 30 weeks and 35 weeks 2 days of gestation and had birth weights ranging from 1090 g to 2950 g. All infants had 1-minute Apgar scores that ranged from 7 to 8 and 5-minute Apgar scores varying between 8 and 9. They were isolated from their mothers immediately after birth and received formula feeding. Three of the four infants were tested using nasopharyngeal swab specimens for RT-PCR 24 to 48 hours after birth and were negative for COVID-19. All the infants were treated in a dedicated area at the neonatal care unit and presented with mild respiratory distress on admission with a Silverman score that varied between 2 and 4/10. During their hospitalization, all the infants also presented with jaundice and underwent phototherapy. Three of them had anemia with hemoglobin levels ranging from 105 to 123 g/L requiring for blood transfusion. The hospital stay varied between 3 and 48 days. Three infants were discharged healthy and one died. Conclusion: This case series suggests the possibility of poor maternal and neonatal outcomes in case of severe COVID-19 in mothers. It also suggests that severe COVID-19 in pregnant women may be a risk factor for prematurity for the newborns. It is crucial to screen pregnant women, to implement infection prevention, control measures and to provide close monitoring of neonates born to mothers with a severe form of COVID-19.