Forthcoming Issue Vol. 20 No. 1 Necrotising enterocolitis in infants with in-utero SARS-CoV-2 exposure in Tshwane, South Africa
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Abstract
Background: Literature suggests an association between in-utero SARS-CoV-2 exposure and necrotising enterocolitis (NEC). This study, conducted in Gauteng, South Africa, investigated whether admitted infants exposed to SARS-CoV-2 in-utero had a higher NEC incidence than non-exposed infants. This study also described the overall incidence of NEC during the COVID-19 pandemic to explore potential associations.
Methods: The evaluation period included one-year pre-COVID-19 (April 2019–March 2020) and a two-year COVID-19 period (April 2020–March 2022). An electronic database was used to identify infants and to collect routine data. Additional databases were used to identify mothers with COVID-19 and SARS-CoV-2-exposed neonates.
Results: All infants exposed to SARS-CoV-2 in-utero tested negative for COVID-19 before admission, indicating no vertical transmissions. Among 32 SARS-CoV-2-exposed infants, one developed NEC (incidence 3.1%), compared to 2.5% in non-exposed infants (p=0.834). NEC incidence was similar across periods (1.8% vs 2.5%; p=0.147). The median day of life of NEC diagnosis was 12 days for both periods. The sex distribution of infants with NEC was similar during both periods.
Conclusion: While this study did not demonstrate a statistically significant increase in NEC incidence during the COVID-19 pandemic, a potential association cannot be excluded, due to the potential pathophysiological mechanisms that support this hypothesis.
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