Utility of Various Clinical Samples in the Diagnosis of Neonatal SARS-CoV-2 Infection: A Retrospective Observational Study

Abstract

Introduction: Coronavirus Disease-2019 (COVID-19) in pregnancy was thought to be associated with an increased risk of stillbirth, Intrauterine Growth Restriction (IUGR), and preterm birth. The current study was undertaken to assess the burden of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection in neonates born to COVID-19-positive mothers. Aim: To assess the role of various clinical samples in the diagnosis of perinatal transmission of SARS-CoV-2 in all three waves of the pandemic. Materials and Methods: A retrospective observational study was carried out in a COVID-19 dedicated tertiary care hospital in Pune, Maharashtra, India from April 2020 to February 2022. Swabs from the umbilical stump and nasopharynx of neonates were collected after birth from neonates born to mothers who were COVID-19 positive at the time of admission for delivery, along with the mother’s placental swab. Results: Over a period of two years, a total of 360 neonates born to 351 COVID-19 positive mothers were included. Thirty neonates showed evidence of SARS-CoV-2 infection. The maximum rate of infection was in the first wave (10.86%). Among the three types of swabs, the umbilical cord sample showed more COVID-19 Reverse Transcription Polymerase Chain Reaction (RT-PCR) positivity (4.88%), followed by the nasopharyngeal swab (4.72%) and placental (3.64%) swab. Conclusion: In the present study, the nasopharyngeal and umbilical swabs were found to be better clinical samples than placental swabs in the diagnosis of SARS-CoV-2 infection in neonates. The rate of perinatal transmission was 8.5%, providing strong evidence of perinatal transmission.

Keywords

• coronavirus disease-2019
• nasopharyngeal swab
• perinatal transmission
• placental swab
• umbilical swab