113 Confirmed SARS-CoV-2 infection in Scottish neonates 2020–2022: a national, population-based cohort study

• Main Authors: McQuaid, Fiona, Goulding, Anna, Lindsay, Laura, Agrawal, Utkarsh, Auyeung, Bonnie, Calvert, Clara, Carruthers, Jade, Denny, Cheryl, Donaghy, Jack, Hillman, Sam, Hopcroft, Lisa, Hopkins, Leanne, McCowan, Colin, McLaughlin, Terry, Moore, Emily, Ritchie, Lewis, Simpson, Colin R, Taylor, Bob, Fenton, Lynda, Pollock, Louisa, Gale, Chris, Kurinczuk, Jennifer J, Robertson, Chris, Sheikh, Aziz, Stock, Sarah, Wood, Rachael
• Format: Conference Proceeding
• Language: English
• Subjects: Births; Cohort analysis; COVID-19; Hospitals; Infections; Intensive care; Intensive care units; Neonates; Newborn babies; Pandemics; Pediatrics; Population studies; Pregnancy; Severe acute respiratory syndrome coronavirus 2
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2023-rcpch.172

ObjectiveTo investigate the incidence of confirmed SARS-CoV-2 infection in neonates (babies aged 0–27 days inclusive) born in Scotland and assess maternal/infant characteristics of cases and hospital admission rates.MethodsThis was a population-based cohort study from 1st March 2020 to 31st January 2022. Data on all pregnancies and resulting live births in Scotland were obtained from the ‘COVID-19 in Pregnancy in Scotland’ (COPS) study dataset. The COPS dataset contained linked information on results of community and in-hospital SARS-CoV-2 viral testing; hospital admissions (including to neonatal units, paediatric wards and paediatric/neonatal intensive care units) and deaths among neonates; and maternal information including SARS-CoV-2 status at delivery, age, ethnicity and Scottish Index of Multiple Deprivation (SIMD) quintile. An admission was considered temporally associated with a baby’s SARS-CoV-2 infection if their first positive viral test occurred during, or in the 7 days prior to, the admission.ResultsLinked data were available for 92009 (of total 92032) livebirths and 141 (of 142) neonates with confirmed infection, with an infection rate of 153/100,000 live births (0.15%). The overall trend in infection rate followed that of the general paediatric population, albeit at a much lower level (figure 1). The infection rate was higher for babies born to mothers who tested positive for SARS-CoV-2 at the time of delivery; 1.8% (15/828) of these babies tested positive at some point in the first 27 days of life. Ninety-two babies (92/141, 65.2%) had a hospital admission which was temporally associated with their positive test (table 1). Six of these babies (6/92, 6.5%) had an episode in paediatric/neonatal intensive care but COVID-19 was not recorded as the main diagnosis in any of these cases. No neonate with a positive SARS-CoV-2 test died.ConclusionThis is the first population-wide study of SARS-CoV-2 in neonates which considers both those in the community and those admitted to hospital. We found that, during the first 23 months of the COVID-19 pandemic, confirmed neonatal SARS-CoV-2 infection was uncommon. Though almost 2/3 of neonates with a positive test were admitted, outcomes were good and admission to intensive care were lower than previously reported.1 2 Continued surveillance is important to monitor the ongoing impact of SARS-CoV-2 on neonates as the pandemic evolves.ReferencesSwann, et al. BMJ 2020.Swann, et al. Paed Res 2022.Abstract 113 Figu