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Severe COVID-19 infection rare in newborns

Published: 10 November 2020

Severe COVID-19 infection appears rare in newborn babies, suggests a new study funded by NIHR.

The analysis, led by researchers from Imperial College London and Oxford University, is the first study analysing COVID-19 infections in newborns across the whole UK.

It found that inpatient care was rarely needed for babies with COVID-19, with only 1 in 1785 newborn babies (0.06%) needing hospital treatment. The study also showed that most babies with COVID-19 were only mildly affected. 

These findings support UK and international guidance to keep mother and baby together even when the mother is suspected or known to have COVID-19. 

The study was funded by the NIHR Policy Research Unit in Maternal and Neonatal Health and Care and published in the journal Lancet Child and Adolescent Health. It traced all babies less than 28 days old with COVID-19 across the UK who needed to be admitted into hospital between the beginning of March and end of April. These infants were traced using a national system called the British Paediatric Surveillance Unit, to which all paediatricians in the UK contribute.

Analysis found that 66 babies required hospital treatment for COVID-19 infection in this period, during which time there were an estimated 118,347 live births across the UK. This is equivalent to 1 in 1785, indicating it was uncommon for infected newborns to require hospital treatment after being delivered to a mother diagnosed with COVID-19 around the time of birth. 

The study also suggests a higher proportion of newborns who develop severe disease will need intensive care or breathing support (36%), compared with older children (13%). However, the study authors add that severe infection in newborn babies is still very rare. 

Read more about NIHR COVID-19 research

Nearly half (45%) of the babies who developed severe infection were from black, Asian or minority ethnic (BAME) groups, and around one in four of the babies (24%) were born prematurely (defined as being born before 37 weeks). These are both higher than would be expected from the UK birth population.

The team says an urgent investigation is needed to understand why so many of the babies hospitalised with severe COVID-19 were from BAME groups.  

Professor Jenny Kurinczuk, co-lead author from the Nuffield Department of Population Health at the University of Oxford, said: “As in our recent study of pregnant women with COVID-19, and the general population, we found a higher than expected proportion of the babies were from black, Asian and ethnic minority backgrounds, which clearly needs further investigation. In the meantime however, parents may find some reassurance that severe COVID-19 infection, even in the first wave of the pandemic, was rare in babies from the BAME community.”   

The study revealed only 17 of the babies were suspected to have caught the infection from their mother, with two of these babies potentially contracting COVID-19 in the womb. Seven of these babies developed COVID-19 despite being separated from their mother for medical reasons immediately after birth. 

When the data were analysed, nearly 90% of the babies had fully recovered from the infection and had been discharged from hospital. The main symptoms of COVID-19 infection in the babies in the study included high temperature, poor feeding, vomiting, a runny nose, cough and lethargy. 

Overall, this study suggests only a small proportion of babies caught COVID-19 from their mother. They explain that, in light of this, if a mother tests positive for COVID-19, her baby does not need to be separated from her at birth. 

Dr Chris Gale, co-lead author of the study from Imperial’s School of Public Health, said: “Parents, and expectant parents, are understandably worried about their babies becoming ill with COVID-19. This study will hopefully provide some reassurance, as it suggests severe COVID-19 infection in newborns is very rare. Most babies only develop mild symptoms when infected with the virus and make a full recovery. This research also supports UK and international guidance to keep mother and baby together even when the mother is known or suspected to have COVID-19.”

Dr Gale added: “Although this study did show that six babies may have contracted hospital-acquired COVID-19, this data was from the beginning of the pandemic, and infection control measures on neonatal and paediatric units have improved dramatically over the past six months.”

Read more about this study on the Imperial College London website.

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