• Jogender Kumar, Praveen Kumar, Shiv Sajan Saini, Venkataseshan Sundaram, Kanya Mukhopadhyay, Sourabh Dutta, Raja Rajan Paulpandian, Piyush Mittal, Swati Das, Monisha Rameshbabu, Phani Priya Mandula, Ankit Ranjan, Deepika Tiwari, Manish Taneja, Ashok Garg, Murlidharan Jayashree, Kapil Goyal, Mini Singh, Goverdhan Dutt Puri, M LakshmiP VPVDepartment of Hospital Administration, Postgraduate Institute of Medical Education & Research, Chandigarh, India., and Rashmi Ranjan Guru.
• Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
• Indian J Med Res. 2022 Jan 1; 155 (1): 189196189-196.

Background & ObjectivesData on neonatal COVID-19 are limited to the immediate postnatal period, with a primary focus on vertical transmission in inborn infants. This study was aimed to assess the characteristics and outcome of COVID-19 in outborn neonates.MethodsAll neonates admitted to the paediatric emergency from August 1 to December 31, 2020, were included in the study. SARS-CoV-2 reverse transcription- (RT)-PCR test was done on oro/nasopharyngeal specimens obtained at admission. The clinical characteristics and outcomes of SARS-CoV-2 positive and negative neonates were compared and the diagnostic accuracy of a selective testing policy was assessed.ResultsA total of 1225 neonates were admitted during the study period, of whom SARS-CoV-2 RT-PCR was performed in 969. The RT-PCR test was positive in 17 (1.8%). Mean (standard deviation) gestation and birth weight of SARS-CoV-2-infected neonates were 35.5 (3.2) wk and 2274 (695) g, respectively. Most neonates (11/17) with confirmed COVID-19 reported in the first two weeks of life. Respiratory distress (14/17) was the predominant manifestation. Five (5/17, 29.4%) SARS-CoV-2 infected neonates died. Neonates with COVID-19 were at a higher risk for all-cause mortality [odds ratio (OR): 3.1; 95% confidence interval (CI): 1.1-8.9, P=0.03]; however, mortality did not differ after adjusting for lethal malformation (OR: 2.4; 95% CI: 0.7-8.7). Sensitivity, specificity, accuracy, positive and negative likelihood ratios (95% CI) of selective testing policy for SARS-CoV-2 infection at admission was 52.9 (28.5-76.1), 83.3 (80.7-85.6), 82.8 (80.3-85.1), 3.17 (1.98-5.07), and 0.56 (0.34-0.93) per cent, respectively.Interpretation & ConclusionsSARS-CoV-2 positivity rate among the outborn neonates reporting to the paediatric emergency and tested for COVID-19 was observed to be low. The selective testing policy had poor diagnostic accuracy in distinguishing COVID-19 from non-COVID illness.

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