ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG CỦA TRẺ SƠ SINH MẮC COVID-19 ĐIỀU TRỊ NỘI TRÚ TẠI BỆNH VIỆN NHI TRUNG ƯƠNG NĂM 2021-2023

Abstract

Objective: Description of clinical and subclinical characteristics of neonates with COVID-19 inpatient treatment at the National Children's Hospital in 2021-2023. Subjects and methods: Description of a case series of infants diagnosed with COVID-19 inpatient treatment at the National Children's Hospital in 2021-2023. Results: The 73 neonates with COVID-19 were mainly full term (83.6%); late-onset neonatal COVID-19 infection (90.4%); the average age of diagnosis was 13.0±7.6 days; 69.8% of children infected with COVID-19 had contact with a source of infection. 75.3% of cases co-infected with other diseases. Clinical symptoms are varied, non-specific, the most common are fever (45.2%), poor feeding (52.1%), respiratory symptoms such as runny nose, stuffy nose (65.8%), cough (61.6%), rapid breathing (46.6%). Common subclinical symptoms were increased Ferritin above 600 ng/ml (32.9%) and D-Dimer increased over 1000ng/mL (56.2%). Premature infants < 37 weeks have a 4.63 times higher risk of severe - critical COVID-19 than term infants (95% CI of OR: 1.14-18.83); neonates with birth weight < 2500 grams were 7.13 times more likely to have severe-critical COVID-19 than neonates with birth weight ≥ 2500 grams (95% CI of OR: 1.42-35, 83); neonates with ferritin index > 600 ng/ml had a 2.87 times higher risk of severe and critical COVID-19 than neonates with ferritin index ≤ 600 ng/ml (95% CI of OR:1.05 -7.89). The difference was statistically significant with p<0.05. Conclusion: COVID-19 can be seen in neonates, mostly of late onset. The clinical manifestations are often varied and non-specific, the most common laboratory findings are elevated ferritin and blood D-dimer. Babies born prematurely, with low birth weight or with a ferritin index > 600 ng/ml have a higher risk of severe COVID-19 than full-term infants with normal weight or with a ferritin index ≤ 600 ng/ml.