Impact of COVID-19 on care of hospitalized newborns

1. In an audit of hundreds of hospitals worldwide, the number of hospitalized newborns with confirmed or suspected COVID-19 was low.

2. Despite having few cases of COVID-19, many hospitals reported shortages of equipment, testing, and personnel that impacted the care of newborns and their families.

Evidence Rating Level: 2 (Good)

Study Rundown: Data from several studies suggests that infants are at low risk of acquiring the coronavirus disease 2019 (COVID-19) compared to adults. However, little is known regarding how the COVID-19 pandemic has impacted hospital care for newborns. This study examined how hospitals caring for infants were affected by COVID-19 in April 2020. A two-part audit was performed by participating hospitals on a single day that assessed the hospital’s census of infants, confirmed and suspected cases of COVID-19, shortages of personnel and equipment, and disruptions to patient care. Results showed that COVID-19 was rare in infants; 275 hospitals worldwide reported a total of 54 confirmed and 311 suspected cases out of 11,341 eligible newborns. However, approximately 70% of hospitals reported some disruption of care to the admitted newborns and their families due to shortages of personnel, equipment, and testing. Accuracy of data from the study may be limited due to differing definitions of suspected cases between hospitals and no objective criteria given for disruptions to patient care. Overall, these findings suggest that although newborns appear to be at lower risk of requiring hospitalization for COVID-19, resource shortages have led to deleterious effects on care of hospitalized infants.

Click to read the study in Pediatrics

Relevant Reading: Epidemiology of COVID-19 Among Children in China

In-Depth [retrospective cohort]: This study was a two-part audit organized by the Vermont Oxford Network (VON) and American Academy of Pediatrics (AAP). Over 434 hospitals participated and 359 completed the audit. 75% of these hospitals were in the United States. The audit was performed on a single day in April 2020 and contained two parts. Part 1 asked hospitals to identify the census of infants within 28 days of birth and the number of confirmed and suspected cases of COVID-19. A suspected case was defined as a patient having symptoms of COVID-19 or exposure to a confirmed or suspected case. Part 2 of the audit asked hospitals to quantify resource shortages and how they impacted the care newborns and their families. 275 hospitals completed part 1 of the audit. The largest number of confirmed and suspected cases in a single hospital was 20 and 40, respectively. Approximately 60% of hospitals reported no confirmed or suspected COVID-19 cases among infants aged 28 days and younger admitted to their hospital. Among the 332 hospitals responding to Part 2 of the audit, 54% reported significant shortages in resources, and 73% reported some level of disruption of care to the infants and their families. The two most significant resource shortages reported were a lack of available testing kits (40% of hospitals) and lack of personal protective equipment (almost 25% of hospitals).

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