SARS-CoV-2 Among Infants <90 Days of Age Admitted for Serious Bacterial Infection Evaluation

• Published in: Pediatrics (Evanston) Vol. 148; no. 4; p. 1
• Main Authors: Paret, Michal, Lalani, Karim, Hedari, Carine, Jaffer, Annum, Narayanan, Nisha, Noor, Asif, Lighter, Jennifer, Madan, Rebecca Pellett, Shust, Gail F., Ratner, Adam J., Raabe, Vanessa N.
• Format: Journal Article
• Language: English
• Published: Evanston American Academy of Pediatrics 01-10-2021
• Subjects: Age; Bacterial infections; Care and treatment; Coronaviruses; COVID-19; Fever; Health aspects; Hospitalization; Infants; Infants (Newborn); Intensive care; Newborn infants; Pediatric research; Pediatrics; Polymerase chain reaction; Reverse transcription; Severe acute respiratory syndrome coronavirus 2; United States; United States > US; New York City New York
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2020-044685

OBJECTIVES To determine the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in infants hospitalized for a serious bacterial infection (SBI) evaluation and clinically characterize young infants with SARS-CoV-2 infection. METHODS A retrospective chart review was conducted on infants <90 days of age hospitalized for an SBI evaluation. The study was conducted at 4 inpatient facilities in New York City from March 15, 2020, to December 15, 2020. RESULTS We identified 148 SBI evaluation infants who met inclusion criteria. A total of 22 infants (15%) tested positive for SARS-CoV-2 by nasopharyngeal reverse transcription polymerase chain reaction; 31% of infants admitted during periods of high community SARS-CoV-2 circulation tested positive for SARS-CoV-2, compared with 3% when community SARS-CoV-2 circulation was low (P < .001). The mean age of infants with SARS-CoV-2 was higher than that of SARS-CoV-2–negative infants (33 [SD: 17] days vs 23 [SD: 23] days, respectively; P = .03), although no age difference was observed when analysis was limited only to febrile infants. An isolated fever was the most common presentation of SARS-CoV-2 (n = 13; 59%). Admitted infants with SARS-CoV-2 were less likely to have positive urine culture results (n = 1 [5%] versus n = 25 [20%], respectively; P = .002), positive cerebrospinal culture results (n = 0 [0%] versus n = 5 [4%], respectively; P = .02), or be admitted to intensive care (n = 2 [9%] versus n = 47 [37%]; P < .001), compared with infants without SARS-CoV-2. CONCLUSIONS SARS-CoV-2 was common among young infants hospitalized for an SBI evaluation during periods of high but not low community SARS-CoV-2 circulation in New York City, although most infants did not require intensive care admission.