Table 1. Characteristics of infants born to mothers with positive SARS-CoV-2 infection.
| Study | n | Region, country | GA range | Infant testing | Respiratory support | Neonatal illness |
|---|---|---|---|---|---|---|
| Infants with negative testing, pending testing or not tested for SARS-CoV-2 | ||||||
| Breslin et al 1 | 18 | New York, USA | Not reported | Negative | Not specified | None |
| Chen et al 2 | 9 | Wuhan, China | 36–39 4/7 | Negative (6/6) | None | Increased myocardial enzymes (1/9) |
| Chen et al 3 | 3 | Wuhan, China | 35/37 3/7 /38 6/7 | Negative | None | None |
| Chen et al 4 | 5 | Wuhan, Chine | 38 6/7 –40 4/7 | Negative | None | None |
| Chen et al 5 | 4 | Wuhan, China | 37 2/7 –39 | Negative (3/3) | CPAP for TTN (1/4) | None |
| Fan et al 6 | 2 | Wuhan, China | 37/36 5/7 | Negative | None | Mild neonatal pneumonia (2/2) |
| Gidlöf et al 7 | 2 | Stockholm, Sweden | 36 2/7 | Negative | CPAP for TTN (1/2½) | None |
| Iqbal et al 8 | 1 | Washington DC, USA | 39 | Negative | None | None |
| ISN-SIN 9 | 7 | Northern Italy | 34 1/7 –40 2/7 | Negative (4/4) a | NIV for prematurity (1/7) | None |
| Khan et al 10 | 17 | Wuhan, China | 35 5/7 –41 | Negative | Not specified | Neonatal pneumonia (5/17) |
| Lee et al 11 | 1 | Daegu, South Korea | 37 6/7 | Negative | None | None |
| Li et al 12 | 17 | Wuhan, China | 33 6/7 –40 4/7 | Negative (3/3) | None | Fetal distress (2/17) |
| Li et al 13 | 1 | Zhejiang, China | 35 | Negative | None | None |
| Liu et al 14 | 11 | Wuhan, China | 34–38 | Not done | None | None |
| Liu et al 15 | 16 | Shanghai, China | Not specified | Not done | None | None |
| Liu et al 16 | 3 | Wuhan, China | 38 4/7 –40 | Negative | None | None |
| Liu et al 17 | 10 | Outside Wuhan | 32–38 3/7 | Not specified | None | Stillbirth for maternal ARDS and shock (1/10) |
| Wang et al 18 | 1 | Suzhou, China | 30 | Negative | None | None |
| Wu et al 19 | 21 | Wuhan, China | 31 5/7 –40 | Negative (4/4) | None | None |
| Yu et al 20 | 6 b | Wuhan, China | 37–41 2/7 | Negative (2/2) | None | None |
| Zambrano et al 21 | 1 | Tegucigalpa, Honduras | 32 | Negative | Not specified | Not specified |
| Zeng et al 22 | 4 | Wuhan, China | Not specified | Negative | None | None |
| Zeng et al 23 | 30 | Wuhan, China | Term (27/30), preterm (3/30) | Negative | None | RDS (3/30), cyanosis (2/30), asphyxia (1/30) |
| Zhang et al 24 | 10 | Wuhan, China | 35 5/7 –41 | Negative | Not reported | Bacterial pneumonia (3/10) |
| Zhu et al 25 | 10 | Wuhan, China | 31–39 | Negative (9/9) b | IMV on DOL 8 (1/10) NIV after birth then IMV on DOL 3 (1/10) |
Shortness of breath (6/10); pneumothorax (1/10); RDS (2/10); Shock, multiple organ failure, DIC and death on DOL 8–9 (1/10); respiratory distress after birth then DIC on DOL 3 (1/10) |
| Infants with equivocal test results for SARS-CoV-2 | ||||||
| Dong et al 26 | 1 | Wuhan, China | 34 2/7 | Negative RT-PCR High IgM/IgG |
None | None |
| Zeng et al 22 | 2 | Wuhan, China | Not specified | Negative RT-PCR High IgM/IgG (2/6) |
None | None |
| Infants with positive testing for SARS-CoV-2 | ||||||
| Wang et al 27 | 1 | Wuhan, China | 39 6/7 | Positive at 36h c | None | Lymphopenia and transaminitis |
| Zeng et al 23 | 3 | Wuhan, China | Term (2/3) Preterm (1/3) |
Positive at ∼48h | NIV for prematurity (1/3) | 1 infant: 31 2/7 wk, fetal distress, asphyxia, low Apgar's scores, RDS, pneumonia, bacteremia |
Abbreviations: ARDS, acute respiratory distress syndrome; CPAP, continuous positive airway pressure; DIC, disseminated intravascular coagulation; DOL, day of life; GA, gestational age (weeks); IMV, invasive mechanical ventilation; ISN-SIN, Italian Society of Neonatology report; NIV, noninvasive ventilation; PT, preterm; RDS, respiratory distress syndrome; SARS-CoV-2, severe acute respiratory syndrome–coronavirus-2; T, term; TTN, transient tachypnea of the newborn.
Notes: Testing for SARS-CoV-2 was performed using quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) from various sources depending on the study:
Breslin et al, Chen Si et al, 2 Chen Y et al, 3 Li et al, 12 Wang et al, 27 Wu et al, 19 Yu et al, Zhang et al, and Zhu et al 2 : newborn nasopharyngeal swab.
Chen et al 2 : amniotic fluid, umbilical cord blood, breast milk and newborn nasopharyngeal swab.
Chen et al 3 : placental tissues and newborn nasopharyngeal swab.
Dong et al: vaginal secretions, breast milk and newborn nasopharyngeal swab (the latter was tested five times).
Fan et al: amniotic fluid, umbilical cord blood, placental tissue, vaginal swab, breast milk and newborn nasopharyngeal swab.
Gidlöf et al: newborn nasopharyngeal swabs (at 34 hours and 4 days of life), vaginal secretions and breast milk.
Iqbal et al: newborn nasopharyngeal swab done at 24 h of life was negative. Additionally, swabs from the maternal sites (amniotic fluid, vaginal side walls and rectum) and neonatal sites (nasopharynx, oropharynx, oral mucosa, skin surface, and rectum) were taken right after delivery but have not yet been processed due to high demand for testing in the laboratory.
ISN-SIN: newborn nasal or nasopharyngeal swabs.
Khan et al: umbilical cord blood and newborn nasopharyngeal swab.
Lee et al: placental tissue, amniotic fluid, umbilical cord blood and newborn nasopharyngeal swabs.
Li et al 13 : amniotic fluid, umbilical cord blood, placenta, breast milk, plasma serum, urine, feces and newborn oropharyngeal swab.
Liu et al 16 : umbilical cord blood (only patient 1), plasma serum, urine, feces and newborn oropharyngeal swab.
Wang et al: newborn nasopharyngeal swab done at 36 hours of life.
Wang et al: amniotic fluid, umbilical cord blood, placental tissue, gastric fluid and newborn nasopharyngeal swab.
Zambrano et al and Zeng et al 22 : newborn plasma serum and nasopharyngeal swabs.
Zeng et al 23 : newborn nasopharyngeal and anal swabs.
The remaining three infants had testing for SARS-CoV-2 but results were pending.
The study by Yu et al. included seven infants born of pregnant women with COVID-19 infection. However, one of those infants was also reported in more detail as a separate case report by Wang et al. For that reason the sample size was decreased to 6 to avoid duplications.
After the result came back positive at 36h of life, RT-PCR from the placental tissue, umbilical cord blood and breast milk were done and were all negative.