COVID-19 infection was less severe and less frequent than other respiratory infections in infants less than 2 months old during the pandemic, according to study findings published in Pediatric Pulmonology.
Investigators sought to determine frequency of COVID-19 infection among infants less than 2 months of age during the pandemic. The secondary outcomes were to assess frequency by COVID-19 variant, and to determine the frequency and burden of other respiratory viruses vs SARS-CoV-2.
The investigators conducted a single-center, retrospective, cross-sectional study from March 2021 through February 2022 at Lille University Hospital in France. Included were all infants less than 2 months of age admitted to the hospital during the study period and subsequently administered a reverse transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 (N=727; mean [SD] age, 0.9 [0.6] months; 43% girls) Of the 727 infants studied, 29% (213) received their RT-PCR test in the hospital, where just over a third (39%) of these infants showed respiratory symptoms, and 71% (514) of infants were tested in the emergency room (ER), where most of the infants (97%) presented with respiratory symptoms.
Overall, 9% (62/727) of the infants had a positive RT-PCR test for SARS-CoV-2, the majority with Omicron variant (57%; 27/47) and Delta variant (36%; 17/47) (15 SARS-CoV-2 variants not screened). Overall, 39% presented with comorbidities (20% prematurity, 15% respiratory disease, 9% digestive disease).
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In children under the age of 2 months, SARS‐CoV‐2 infections appear to have at most equal or less burden of disease than infections by RSV or other respiratory viruses.
Among the 565 patients with a multiplex RT-PCR test, 325 tested positive; 17 patients had a positive SARS-CoV-2 test and a positive multiplex RT-PCR test. Other viruses included enterovirus/rhinovirus (153 patients), respiratory syncytial virus (RSV; 150 patients), para-influenza (25 patients), and other human coronaviruses (26 patients).
Infants with a positive SARS-CoV-2 test vs positive test for other respiratory viruses were more likely to have fever, isolated fever, and diarrhea. Those with a positive test for other respiratory viruses were significantly more likely to present symptoms of bronchiolitis.
The investigators noted infants with a positive SARS-CoV-2 test were less likely to have required intensive care admission (P =.01), enteral nutrition (P =.03), or respiratory support (P =.001). Infants with a positive SARS-CoV-2 vs other respiratory viruses underwent a shorter hospital stay (5 days vs 7 days; P =.007).
Among the infants presenting in the ER, more than 80% were subsequently admitted to the hospital (76% of infants positive for SARS-CoV-2; 82% of infants positive for other respiratory viruses).
Study limitations include missing data on patients transferred to other hospitals (15% of total) and screening differential bias, with 22% of patients undergoing SARS-CoV-2 testing without a multiplex RT-PCR test.
“In children under the age of 2 months, SARS‐CoV‐2 infections appear to have at most equal or less burden of disease than infections by RSV or other respiratory viruses,” the study authors concluded. The investigators wrote, “Systematic viral detection with rapid results could be introduced to reduce the proportion of antibiotic prescriptions in children with viral infections.”
Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
