AUTHOR=Shaiba Lana A. , Hadid Adnan , Altirkawi Khalid , Alnamnakani Mahdi A. , Almutayliq Abdulaziz A. , Alharbi Areen T. , Hijazi Asmar M. , AlMoosa Khalid M. , AlSaud Nora F. , Murshid Rozan E. , AlMuhanna Wejdan S. , Aldawsari Nasser A. , Bin Hadyan Maryam F. , Almaghrabi Rana , Alsofayan Yousef M. , Alahmari Ahmed A. , Almuzaini Yasir S. , Alamri Fahad A. , Khan Anas A. , Shah Prakesh S. TITLE=SARS-CoV-2 Positivity in Early Infancy: A National Cohort From Saudi Arabia JOURNAL=Frontiers in Pediatrics VOLUME=10 YEAR=2022 URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.849659 DOI=10.3389/fped.2022.849659 ISSN=2296-2360 ABSTRACT=Background

Data on SARS-CoV-2 in infants ≤ 90 days are limited with conflicting reports regarding its presentation and outcomes.

Methods

We conducted an ambispective cohort study using prospectively collected Health Electronic Surveillance Network Database by the Ministry of Health, Saudi Arabia. Infants of ≤ 90 days of age who had a positive RT-PCR test for SARS-CoV-2 virus were included. Patients were divided in Early neonatal (0–6 days), late neonatal (7–27 days), and post- neonatal (28–90 days) groups and were compared for clinical characteristics and outcomes by contacting parents and collecting information retrospectively.

Results

Of 1,793 infants, 898 infants were included for analysis. Most infants in the early neonatal group had no features of infection (tested based on maternal positivity), whereas most infants in the late and post- neonatal groups were tested because of clinical features of infection. Fever and respiratory signs were the most common presenting feature in the late and post-neonatal groups. Hospitalization was higher in the early neonatal group (80%), compared to the two other groups. The overall mortality in the cohort was 1.6%.

Conclusion

SARS-CoV-2 infection in infants ≤ 90 days might not be as rare as previously reported. The clinical presentation varies based on age at positive RT-PCR result.