Current evidence on vertical transmission of severe acute respiratory syndrome Corona-virus 2 (SARS-CoV-2) and neonatal outcome among exposed newborns is emerging and posing a challenge for preventive interventions. Perinatal transmission to the neonates especially during breastfeeding and rooming in is also relatively unknown. This prospective observational study was conducted in Kalinga Institute of Medical Science (KIMS) from 1st May to 20th October 2020. A total of 165 neonates born to SARS-CoV-2 infected mothers were enrolled. Real time polymerase chain reaction (RT PCR) testing was done in the first 32 neonates in the initial 24 h of life. The clinical characteristics of 162 mothers and 165 neonates were analyzed. Mode of delivery was by caesarian section in most (n=103, 60%) cases. Three (3/32, 9.4%) inborn and 6 out born neonates were SARS-CoV-2 positive. Thirty-eight (23%) babies needed neonatal intensive care. Clinical characteristics of neonates were meconium-stained amniotic fluid (MSAF [23.63%]), prematurity (16.9%), respiratory distress (10.5%), moderate to severe hypoxic ischemic encephalopathy (3.6%), sepsis (7%) and hyperbilirubinemia (8.7%). Out of 138 stable babies kept on mother side and initiated breastfeeding, none of them developed any signs and symptoms attributable to SARS-CoV-2. Five (3%) neonates died in COVID hospital of which one baby was SARS-CoV-2 positive.
To conclude there is an increased incidence of meconium-stained liquor and caesarean section deliveries in SARS-COV-2 positive mothers. The KIMS Treatment Team found possible vertical transmission in 9.4% of cases. Hypoxic ischaemic encephalopathy is the leading cause of mortality in our COVID-19 NICU. None of the neonates developed signs and symptoms of SARS-CoV-2 infection during rooming in and breastfeeding.
This study was conducted in KIMS COVID Hospital by Professor Nirmal Kumar Mohakud, Asso. Prof. Manas Kumar Nayak, Santosh Kumar Panda, Subhra Snigdha Panda, Soumini Rath, and Dr. Arpan Ghosh.
The Treatment Team has expressed thankfulness to the management for providing the infrastructure and diagnostic facility to carry-out the work. The Team is also thankful to KIIT-TBI for their help and guide to shape the manuscript.