350 SARS-CoV-2 infection in infants and newborns: a tunisian single-centre experience

GoalAvailable data suggest that SARS-Cov-2 infection is usually mild in children. The aim of this study was to describe clinical and biological features and outcome of Covid 19 in Tunisian infants and newborns.MethodWe reviewed files of patients <12 months, diagnosed with Covid 19 and hospitalized in pediatric ‘C’ department of Bechir Hamza children’s hospital between 15 March 2020 and 15 April 2021.ResultsWe enrolled thirteen infants and newborns: 11 boys and 2 girls.Median age was 3 months [10 days;15 months]. Five were aged between 10 and 28 days, seven were aged between 1 and 12 months. Three patients had serious underlying diseases: two cases of interventricular communication and one case of myelomeningocele and meningitis. Six patients had exposure with persons confirmed to Covid 19. Most frequent signs were: fever (11/13), diarrhea and vomiting (3/13), cough (3/13), nasal congestion and grunting (2/13).On admission, physical examination found high fever in seven cases. Two infants had marbled skin and one newborn had jaundice. Two patients had tachypnea. Median heart rate was 135. Three patients had Oxygen saturation <94%.Laboratory testing found median white blood cell count 9496/mm3 [3980-17200], median neutrophil count 4540/mm3 [480-10260], median lymphocyte count 3370/mm3 [990-8020], median monocyt count 1701/mm3 [990-3370] and median C-reactive-protein 4,45mg/l [0-16]. The patient who had jaundice had total bilirubin level at 182 µmol/L and unconjugated bilirubin level at 169 µmol/L. Five patients had lumbar puncture and were all negative.All patients received symptomatic treatment. Two patients received oxygen through nasal canula and one patient was put on non invasive ventilation. As we received the result of RT PCR, all patients were admitted in isolation ward.Median duration of symptoms was 3 days [3-7 days]. Median hospital stay was 3 days [2-7 days]. Death occurred one patient with interventricular communication. He had cardiogenic shock 3 days after his diagnosis with Covid 19.ConclusionPrevalence of Covid 19 is less in children than in adults. In our case serie of 13 infants, five were newborns. Contamination was caused mostly by another family member. Fever, cough and gastrointestinal signs were the most common symptoms. One death occurred in an infant with interventricular communication. None of our patient had multisystem inflammatory syndrome after his infection.