Wednesday 23 September 2020

BPLS T15

 

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Chi H, Chiu NC, Tai YL, et al. Clinical features of neonates born to mothers with coronavirus disease-2019: A systematic review of 105 neonates. J Microbiol Immunol Infect. 2020 Aug 14. pii: S1684-1182(20)30182-1. doi: 10.1016/j.jmii.2020.07.024. (Systematic review)


Abstract

BACKGROUND: Despite the increasingly recognized impact of novel coronavirus disease (COVID-19), caused by severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2), on many aspects of health in adults and children, its effects on neonates born to infected mothers remain unclear. We conducted this study to investigate the outcomes of neonates born to mothers with COVID-19.

METHODS: We searched the medical databases from inception to March 31, 2020 to perform a systematic review of outcomes in neonates born to mothers with COVID-19. Data were pooled using a random effects regression model. Primary and secondary outcomes were neonatal clinical outcomes and infectious status, respectively.

RESULTS: Fourteen studies involving 105 neonates fulfilling the study criteria were identified. The rates of preterm neonates and those small for gestational age (SGA) were 25 (23.8%) and 10 (11.2%), respectively. Among 91 neonates who were tested, 8 (8.8%) were positive for nucleic acids or antibodies for SARS-CoV-2. Additionally, 28 (26.7%) of the neonates were symptomatic and two test-negative neonates died, including one stillbirth. Between test-positive and test-negative groups, the rates of SGA, preterm delivery, duration between maternal symptom onset and delivery, and perinatal complication were not significantly different; but the rate of symptomatic after birth reached significant difference (62.5% vs 20.5%, p = 0.008).

CONCLUSIONS: Most neonates born to infected mothers had favorable outcomes. Although direct evidences of intrauterine infection were scarce, the risk of intrauterine infection should be considered based on a positive test in 8.8% of the neonates. Symptomatic neonates born to infected mothers should receive tests for SARS-CoV-2 to initiate appropriate treatment and quarantine. Further studies are warranted to assess the outcomes of COVID-19 in neonates.



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In my youth I thought of writing a satire on mankind; but now in my age I think I should write an apology for them. -Horace Walpole, novelist and essayist (24 Sep 1717-1797)



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WOOD- The only time a woman really succeeds in changing a man is when he is a baby."


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KELLY- 
"Autumn is my favorite season."



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Early use of combined exogenous surfactant and inhaled nitric oxide reduces treatment failure in persistent pulmonary hypertension of the newborn: a randomized controlled trial

  • Correction to this article was published on 07 September 2020

Abstract

Objective

To evaluate whether combined surfactant with inhaled nitric oxide (iNO) use will prevent newborns with hypoxemic respiratory failure (HRF) from developing an Oxygenation Index (OI) > 40.

Methods

100 term newborns with acute HRF (OI ≥ 20) were randomized to: Surfactant+iNO: received iNO plus up to two doses of surfactant or iNO-Controls: received iNO+placebo. Main outcome was the development of severe HRF (OI > 40) despite iNO use.

Results

Baseline mean ± SD OI was 37.4 ± 14 for the Surfactant+iNO group and 38.2 ± 16 for the controls. Infants receiving surfactant+iNO improved their oxygenation faster, resulting in lower OI at 24 h: 12.9 ± 9 vs 18.7 ± 11 of controls, p < 0.05; and a lower proportion developing OI > 40: 24%(12/50) vs 50%(25/50) of controls, p < 0.02. Fewer infants receiving surfactant+iNO presented the combined outcome of death or ECMO: 16%(8/50) compared to 36%(18/50) of controls, p < 0.05.

Conclusions

Early use of combined surfactant+iNO improves oxygenation preventing the progression to severe HRF. This may reduce mortality and ECMO need.










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Science is not only compatible with spirituality; it is a profound source of spirituality - Carl Sagan


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AUTUMN EQUINOX


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FIRST 1000 DAYS-CONCEPTION TO 2 YRS


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Cyclones of Color at Jupiter’s North Pole
Cyclones at the north pole of Jupiter appear as swirls of striking colors in this extreme false color rendering of an image from NASA’s Juno mission.


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DIRECT PRESSURE , TOURNIQUET, SPL HEMOSTATIC DRESSINGS

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