TITLE:
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
AUTHORS:
Dominique Enyama, D. Noukeu Njinkui, I. Rakya, D. Djomo Tamchom, R. Tiokeng Nenzeko, C. Mbakop Tchogna, M. C. Bissa, S. R. Wekang Tcheuffa, D. Kamdem, A. Ngalame, H. Neng, D. Mwadjie, Ndongo Eteme, F. Kemta Lekpa, S. R. Simeni Njonnou, S. P. Choukem, G. P. Ngaba, E. T. Mboudou
KEYWORDS:
COVID-19 Infected Mothers, Premature Newborns, Severe Respiratory Distress, Outcome, Cameroon
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.10 No.4,
December
4,
2020
ABSTRACT: 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.