Published in the journal Pediatrics , the study specifically found that infection rates with the virus that causes COVID-19 were higher among infants hospitalized, not for COVID-19, but because they were being evaluated for a possible severe bacterial infection (SBI). ) during periods of high COVID-19 circulation in New York City.
The study also found that COVID-19 positivity rates in this age group were lower when infection rates in the city were low.
Led by researchers at NYU Langone Health, the study also examined the clinical course of infection in young infants and found that the most common presentation of COVID-19 was fever without other symptoms.
"Improving our knowledge of how COVID-19 infection affects young infants is important for informing clinical practice and for planning public health measures such as vaccine distribution," says Vanessa N. Raabe, MD, assistant professor in the NYU Langone Departments of Medicine and Pediatrics, in the Division of Pediatric Infectious Diseases, and one of the study’s principal investigators.
New York City was the early epicenter of COVID-19 in the United States, with more than 190,000 infections reported during the peak of the New York epidemic between March and May 2020. Three percent of reported cases were in children under 18 years of age, although these numbers may underestimate the true incidence given the lack of adequate testing.
Most children infected with the disease were asymptomatic or had mild symptoms.
However, cases of severe illness have been reported, and some reports suggest that young babies may be at higher risk for severe illness than older children.
Young babies are often treated with antibiotics in the hospital when they have a fever until doctors can make sure they don’t have a serious bacterial infection, such as meningitis or a bloodstream infection, the study authors say.
"Because fever is a common symptom of COVID-19 in children, doctors should consider COVID-19 as a possible cause of fever and not rely solely on laboratory or imaging results to guide decision-making on whether or not to test hospitalized babies for COVID. -19," says Dr. Raabe.
The current study analyzed data from infants younger than 90 days admitted for SBI screening at NYU Langone Health and NYC Health+/Bellevue Hospitals between March and December 2020. Among 148 infants, 15 percent gave positive for COVID-19, and two of the 22 infants with COVID-19 required ICU admission but were safely discharged. Specifically, the team found that only 3 percent of babies tested positive during periods of low circulation in the community, compared to 31 percent in communities with high infection rates.
The team also found a relatively low incidence (six percent) of infection of hospitalized babies with other commonly occurring viruses, whether or not they have COVID-19. "This likely reflects community-wide declines in other respiratory viruses reported in New York during the study period due to improved infection control practices, such as social distancing and mask wearing, at the height of the pandemic," Raabe says.
| The researchers recommend that doctors continue to screen young infants who present with fever for bacterial infections, regardless of COVID-19 status, and given the potential serious consequences if left untreated. |
"It may be intuitive that what is happening in children reflects conditions in the surrounding community, but we are reassured that the evidence confirms this relationship," says lead author Michal Paret, MD, member of the Department of Pediatrics, Division of Pediatric Diseases. Infectious Diseases at NYU Langone.
"The epidemiology of COVID-19 continues to evolve with the emergence of virus variants and the implementation of vaccination. In the face of these changes, clinicians should continue to study this age group, with the goal of ultimately determining whether a testing strategy selective or universal best serves the long-term health of babies.
