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CC BY-NC-ND 4.0 · Am J Perinatol 2024; 41(S 01): e1698-e1708
DOI: 10.1055/a-2065-4714
Original Article

Epidemiology and Clinical Features of COVID-19 among 4,015 Neonates in Iran: Results of the National Study from the Iranian Maternal and Neonatal Network

David A. Schwartz 
1   Perinatal Pathology Consulting, Atlanta, Georgia
,
Parisa Mohagheghi
2   Department of Neonatology, Iran University of Medical Sciences, Tehran, Iran
,
Fereshteh Moshfegh
3   Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran
,
Nazanin Zafaranloo
4   Department of Pediatrics, Omid Hospital, Iran University of Medical and Sciences, Tehran, Iran
,
Narjes Khalili
5   Department of Community and Family Medicine, Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
,
Mohammad Heidarzadeh
6   Department of Neonatology, Tabriz University of Medical Sciences, Tabriz, Iran
,
Abbas Habibelahi
7   Department of Neonatology, Neonatal Health Office, Ministry of Health IR, Tehran, Iran
,
Roya Ghafoury
8   Student Research Committee, School of Medicine, Iran University of Medical and Sciences, Tehran, Iran
,
Fatemeh Afrashteh
8   Student Research Committee, School of Medicine, Iran University of Medical and Sciences, Tehran, Iran
› Author Affiliations Funding Funding for this project was obtained from the UNICEF office in Iran.
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Abstract

Objective The coronavirus disease 2019 (COVID-19) pandemic had a significant impact on pregnant women and neonates in Iran. This retrospective study describes the national experience among neonates having suspected and confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection following hospital admission to examine the epidemiology, demographic, and clinical features.

Study Design All nationwide cases of suspected and confirmed neonatal SARS-CoV-2 infection were drawn from the Iranian Maternal and Neonatal Network (IMaN) between February 2020 and February 2021. IMaN registers demographic, maternal, and neonatal health data throughout Iran. Statistical analysis of demographic, epidemiological, and clinical data were performed.

Results There were 4,015 liveborn neonates having suspected or confirmed SARS-CoV-2 infection that fulfilled the study inclusion criteria identified in the IMaN registry from 187 hospitals throughout Iran. There were 1,392 (34.6%) neonates that were preterm, including 304 (7.6%) less than 32 weeks' gestation. Among the 2,567 newborns admitted to the hospital immediately after birth, the most common clinical problems were respiratory distress (1,095 cases; 42.6%), sepsis-like syndrome (355; 13.8%), and cyanosis (300 cases; 11.6%). Of 683 neonates transferred from another hospital, the most frequent problems were respiratory distress (388; 56.8%), sepsis-like syndrome (152; 22.2%), and cyanosis (134; 19.6%). Among 765 neonates discharged home after birth and subsequently admitted to the hospital, sepsis-like syndrome (244 cases; 31.8%), fever (210; 27.4%), and respiratory distress (185; 24.1%) were most frequent. A total of 2,331 (58%) of neonates required respiratory care, with 2,044 surviving and 287 having a neonatal death. Approximately 55% of surviving neonates received respiratory support, compared with 97% of neonates who expired. Laboratory abnormalities included elevations of white blood cell count, creatine phosphokinase, liver enzymes, and C-reactive protein.

Conclusion This report adds the national experience of Iran to the list of reports from multiple countries describing their experience with COVID-19 in neonates, demonstrating that newborns are not exempt from COVID-19-morbidity and mortality.

Key Points

  • Most common clinical problem was respiratory distress.

  • Sepsis-like syndrome was also frequently present.

  • A total of 58% of all neonates required respiratory care.

Keywords

COVID-19 - SARS-CoV-2 - Iran - neonatal COVID-19 - neonatal infection - coronavirus infection

Ethical Approval

Anonymous patient data were obtained with permission from the Neonatal Health Office of the Iran Ministry of Health and Medical Education in Tehran. The ethical issues of this study were approved in the Vice Chancellor for Research Affairs of Faculty of Medicine, Iran University of Medical Science. The ethics committee code is IR.IUMS.REC.1399.1365. This study was performed in accordance with the principles stated in the Declaration of Helsinki.




Publication History

Received: 17 October 2022

Accepted: 10 March 2023

Accepted Manuscript online:
29 March 2023

Article published online:
18 May 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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