Epidemiological Features of Neonates With COVID-19 Infection in Iran

Objective: Although, the COVID-19 Pandemic has drawn the attention of physicians and researchers from all corners of the globe since it has been out broken in different countries, we have also started to invest more about the epidemiological features of neonates that had been affected by COVID-19 in Iran till now. Method: This is a cross-sectional retrospective study including all neonates from a National Registry supported by Iranian Maternal and Neonatal Network (IMaN). Since February 2020 till February 2021, data of neonates under 28 days who were diagnosed with suspected or confirmed COVID-19 has been registered in this network were collected. General data including epidemiological, clinical outcomes and infection-related information were collected. Results: : In our retrospective study, data of 4015 neonates admitted to hospital all over the country and reported in IMAN is included. Totally 3725 PCR tests were performed (92.8% of admitted neonates) and from these neonates 825 (20.5%) showed positive PCR test. There were no differences between gender, weight and gestational age in neonates with positive and negative PCR test. Neonatal clinical findings were dependent to the type of admission. Respiratory distress was the most common sign in neonates, who were admitted immediately after birth (63.9%), and who were transferred from another hospital (17%); however in those who were admitted after one to several days after discharge (19.1%), the most common sign were sepsis like syndrome (31.8%) and fever (27.4%). Almost 50% of admitted neonate`s mothers had positive PCR test (25% during pregnancy and 24.3% after delivery). The most important factor of neonatal death was need for respiratory support (aOR=18.17, 95% CI; 9.24– 35.69). Gestational age of <32 weeks (aOR=2.35, 95% CI; 1.35-4.10) and birth weight of <1500 grams (aOR= 3.47, 95% CI; 1.96-6.17) were the other two factors that correlated to death. Conclusion: This is the largest study of neonatal COVID-19 diseases in Iran published to date. The most common signs of COVID-19 diseases found in neonates are respiratory distress and sepsis-like syndrome.