COVID-19 Infection in The Newborn: Guidelines for care in Nigeria.

  • COVID-19 stands for coronavirus disease of 2019
  • Caused by the SARS-CoV-2 virus, a novel strain of coronavirus that causes severe acute respiratory syndrome (SARS).
  • The disease was first described in Wuhan China in December 2019.
  • Described as a pandemic in March 2020 by WHO

Management of infants of mothers with suspected or confirmed COVID-19 infection

  • When consult for delivery is received for a confirmed or suspected COVID-19 pregnant woman, the most senior doctor should be notified.
  • Universal precautions should be practiced at all times
  • Number of people in the delivery room should be limited to the barest minimum
  • All health workers that attend the delivery must wear full PPE
  • At delivery, provide routine delivery room care: dry, stimulate and keep warm with mother in skin-to-skin contact. Ensure mother completes hand hygiene and if she is symptomatic, she should also wear a mask.
  • Provide routine newborn care
  • Neonatal resuscitation should be undertaken when indicated – resuscitation should be performed either in a separate room or in the delivery room, with the resuscitation area at least 2 metres from the mother.
  • Avoid procedures that can result in aerosolization and perform these only when ABSOLUTELY necessary. Such procedures include suctioning, manual ventilation, intubation, noninvasive positive-pressure ventilation, cardiopulmonary resuscitation, connecting/disconnecting a patient to or from a ventilator.

COVID-19 testing in newborns

  • At birth, all exposed babies should have samples for COVID-19 taken from skin surface/umbilical swabs or the amniotic fluid. Blood, urine or stool samples should also be collected and send for testing though yield for COVID-19 is said not to be high compared to nasopharyngeal swabs
  • Testing of nasopharyngeal swabs should be done after 24 h of life as yield is better

Admission and further management

  • Routine isolation of exposed infants from the mother is not recommended
  • All COVID-19 exposed infants requiring admission should be admitted into the designated isolation ward.
  • Babies with positive results who are symptomatic should be transferred to the designated neonatal ward for COVID-19 patients.
  • These isolation units should have separate doctors, nurses and other support staff who have been trained and must wear full PPE while in the units
  • Universal precautions must be followed at all times
  • Subsequent care should be provided for all infants as indicated for co-morbidities

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