NEW YORK, June 30, 2021 /PRNewswire/ -- How common
COVID-19 is among infants may depend on the degree of the pandemic
virus circulating in a community, a new study finds.
Published online June 30 in the
journal Pediatrics, the study found specifically that rates
of the infection with the virus that causes COVID-19 were higher
among infants hospitalized, not for COVID-19 – but instead because
they were being evaluated for a potential serious bacterial
infection (SBI) – during periods of high COVID-19 circulation in
New York City. The study also
found rates of COVID-19 positivity in this age group were lower
when infection rates in the city were low.
Led by researchers from NYU Langone Health, the study also
examined the clinical course of the infection in young infants and
found that the most common presentation of COVID-19 was a fever
without other symptoms.
"Enhancing our knowledge of how COVID-19 infection affects young
infants is important for informing clinical practice, and for
planning public health measures such as vaccination distribution,"
says Vanessa N. Raabe, MD, assistant
professor in NYU Langone's 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 reported infections during
the peak of the NYC epidemic between March and May in 2020. Three
percent of the 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 young
infants may be at higher risk for severe disease than older
children.
Young babies are often treated with antibiotics in the hospital
when they run a fever until doctors can make sure they don't have a
serious bacterial infection, such as meningitis or a bloodstream
infection, say the study authors.
"Because fever is a common symptom of COVID-19 in children,
clinicians must consider COVID-19 as a potential cause of fever and
not solely rely on laboratory or imaging results to guide
decision-making on whether or not to test hospitalized infants for
COVID-19," says Dr. Raabe.
The current study analyzed data from infants less than 90 days
of age admitted for SBI evaluation at NYU Langone Health hospitals
and NYC Health + Hospitals/Bellevue Hospital between March and
December 2020. Among 148 infants, 15
percent tested positive for COVID-19, and two of the 22 infants
with COVID-19 required ICU admission, but were discharged safely.
Specifically, the team found that only 3 percent of infants tested
positive during periods of low community circulation, compared to
31 percent in communities with high infection rates.
The team also found a relatively low incidence (six percent) of
infection of the hospitalized infants with other commonly occurring
viruses, whether or not they had COVID-19. "This likely reflects
community-wide decreases in other respiratory viruses reported in
New York during the study period
due to enhanced infection control practices, like social distancing
and mask wearing, at the height of the pandemic," says Raabe.
The researchers recommend clinicians continue to assess young
infants that present with fevers for bacterial infections,
regardless of the COVID-19 status, and given the potential severe
consequences if not treated.
"It may be intuitive that what is happening in children reflects
conditions in the surrounding community, but we find it reassuring
that the evidence confirms this relationship," says lead author
Michal Paret, MD, a fellow in the
Department of Pediatrics, Division of Pediatric Infectious Diseases
at NYU Langone. "The epidemiology of COVID-19 continues to evolve
with the emergence of variant viruses and vaccination
implementation. In the face of these changes physicians need to
continue studying this age group, with the goal of determining
ultimately whether a selective or universal testing strategy best
serves the health of infants long-term."
Additional research is needed on young infants evaluated in a
wider range of settings, including the emergency department and
outpatient clinics, to truly understand the full impact of COVID-19
in this age group.
Along with Dr. Raabe and Dr. Paret, authors of the study from
the Department of Pediatrics were Adam J.
Ratner, MD; Gail F. Shust,
MD; Rebecca Pellet Madan, MD;
Jennifer L. Lighter, MD;
Asif Noor, MD; Annum Jaffer, MD; and
Karim Lalani, MD.
Media Inquiries
Katie Ullman
Phone: 212-404-3511
Kathryn.ullman@nyulangone.org
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SOURCE NYU Langone Health