COVID-19 TRIAGE AMONG HOSPITALIZED NEONATES IN TUZLA CANTON

Abstract

Aim: To evaluate the incidence, characteristics, transmission, and outcomes of COVID-19 infection in hospitalized neonates in Tuzla Canton and to emphasize the importance of quality triage in the prevention and control of infection.

Material and Methods: A retrospective cohort study, which included all consecutive neonates suspected of COVID-19 infection, and which required screening supervision in the triage department, from those who required hospital treatment at the Pediatric Clinic, University Clinical Center Tuzla for 12 months. (January 1 to December 31, 2020). Statistical analysis applied standard methods, and the research was approved by the Ethics Committee of the institution.

Results: In the observed period, in the neonatal triage department, 111 neonates suspected to COVID-19 were treated, with no gender difference. Among them were 92 neonates of mothers suspected of COVID-19 (66 admitted immediately after birth, 26 readmitted after discharge home), and 19 neonates of mothers positive for COVID-19 (16 admitted immediately after birth, 3 readmitted). Cesarean delivery was a more common delivery option, and fever a more common symptom in COVID-19 positive mothers, but without statistical significance. The neonates from COVID-19 suspected mothers formed a heterogeneous group, with common perinatal problems, while neonates from COVID-19 positive mothers, hospitalized immediately after birth, were almost term neonates with appropriate birth weight, without need for a lot of treatment. All neonates hospitalized immediately after birth were negative for COVID-19.  The only three COVID-19 positive neonates were readmitted after previous discharge home, and they had mild symptoms, mostly one-day fever, and they all recovered completely. All of these neonates are under further follow-up after discharge from the hospital, and all are, for now, in good general condition, and all have continued to breastfeed.

Conclusion: Neonates born to mothers with positive COVID-19 infection generally have favorable outcomes, with no convincing case of vertical transmission. Neonatal COVID-19 is mostly asymptomatic, acquired postnatally, and associated with favorable outcomes. The importance of quality triage in the prevention and control of infection is crucial, with consistent implementation of safe practices including proper patient isolation and appropriate protective equipment.