NEONATAL RESPIRATORY ISSUES IN INFANTS OF COVID-19 INFECTED MOTHERS

Аннотация

The COVID-19 pandemic has introduced a variety of challenges, particularly for pregnant women and their newborns. Neonatal respiratory issues in infants born to mothers infected with COVID-19 have emerged as a significant concern. This article examines the respiratory complications seen in neonates born to COVID-19-positive mothers, including the mechanisms behind these complications, the severity of symptoms, and the strategies used for managing these conditions. Additionally, it reviews the existing literature on the effects of maternal COVID-19 infection on neonatal lung development, birth outcomes, and the overall prognosis for infants. The goal of this review is to shed light on the potential risksand inform clinical practices tobetter manage neonates inthe post-pandemicera. Keywords: Neonatal respiratory distress, COVID-19, maternal infection, preterm birth, neonatal intensivecare unit(NICU), respiratory complications,maternal antibodies Introduction: The novel coronavirus responsible for the current pandemic of COVID-19 was unknown to humans until it caused cases of severe pneumonia in Wuhan, China, in December 2019. In a span of three months, the virus had spread to various other countries, causing a large number of severe diseases and deaths. The virus has an R0 between 2 and 4, andover 20-30% ofall cases result insevere disease, most ofwhom require admission tothe ICU with high-flow oxygen or mechanical ventilation and tube support in severe forms of the disease. High mortality and morbidity rates were evident, especially in the aged population, and risk factors such as hypertension, diabetes, and cardiovascular disease have been implicated in the severe forms of the disease. Patients with compromised pulmonary function and protective response overdrive were seen with an augmented course of the disease. Pregnant women, despite their apparently impaired immune system and physiological impairment, do not fare any worse than the general population, with no additional mortality or morbidity risk demonstrated in the women aged four to sixty. The vast majority of the neonates born did not acquire COVID-19 after birth, and only a few cases of infected and symptomatic neonates were reported. However, in large innovative trials conducted, RNA was detected in swabs of neonates born to mothers with confirmed COVID-19, and one case of transplacental infection transmission was reported. Thus, despite the fact that no certain dataare available regarding thecausality oftransplacental infection transmission in neonates, the possibility should not be dismissed. There is also increasing evidence of teratogenic effects of the virus on fetal brain neurotropism and adverse uterine-placental maternal adaptiveperfusive processes. 98,7:ROTCAFTCAPMI.SECNEICS LACIDEM,5202, yraurbeF,5emuloV gro.srehsilbupcimedaca.www BackgroundandRationale Infants born to mothers infected with severe acute respiratory syndrome coronavirus-2 are at risk for respiratory depression, temperature instability, hypoglycemia, and the need for resuscitation at birth, not only from the viral infection but also from other neonatal respiratory issues. We further examined the neonatal respiratory complications at birth, including infants who needed noninvasive or invasive respiratory support, chest X-ray tests, surfactant replacement therapy, systemic corticosteroid treatment, high-frequency oscillatory ventilation, nitric oxide inhalation, extracorporeal membrane oxygenation, and the death of mothers infected with SARS-CoV-2. A total of 1,055 infants were included; 343 (32.5%) experienced respiratory complications at birth, and 342 (32.4%) needed noninvasive respiratory support. A chest X-ray was performed in 305 (29.0%) infants, and surfactant replacement therapy was required in 11 (1.1%) infants. Infants requiring noninvasive or invasive respiratory support in the neonatal intensive care unit were preterm with low birth weight and were exposed to meconium-stained amniotic fluid. Neonatal respiratory issues were common in infants of SARS-CoV-2-infected mothers, especially in preterm and low birthweight infants, and theneed for noninvasiverespiratory support was mild. ScopeandSignificance SARS-CoV-2 infection has been a major public health threat worldwide, and limited data are available about the possible influence of this infection on maternal, fetal, and neonatal outcomes. This review describes the potential impact of COVID-19 on maternal, fetal, and neonatal well-being and focuses on the respiratory issues of neonates directly affected by SARS-CoV-2 infection and on the impact of the HIV virus during pregnancy on the health ofnewborns in the absence of maternal SARS-CoV-2 infection. The basis for the pulmonary and gastrointestinal coexistence of these two viral infections, which are of great importance during pregnancy, are epidermal growth factor receptoractivation andtheautophagy process. With this analysis, we aim to support clinicians handling