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Original research
Rapid systematic review of neonatal COVID-19 including a case of presumed vertical transmission
  1. Morris Gordon1,2,
  2. Taher Kagalwala2,
  3. Karim Rezk2,
  4. Chris Rawlingson2,
  5. M Idris Ahmed2,
  6. Achyut Guleri3
  1. 1 Biomedical evidence synthesis and translation to practice unit, University of Central Lancashire, Preston, UK
  2. 2 Families division, Blackpool Victoria Hospital, Blackpool, UK
  3. 3 micrbiology department, Blackpool Victoria Hospital, Blackpool, UK
  1. Correspondence to Dr Morris Gordon; Mgordon{at}


Objective To carry out a systematic review of the available studies on COVID-19 (coronavirus disease 2019) in neonates seen globally since the onset of the COVID-19 global pandemic in 2020. The paper also describes a premature baby with reverse transcription (RT)-PCR-positive COVID-19 seen at the Blackpool Teaching Hospitals NHS Foundation Trust, UK.

Design We conducted a multifaceted search of the Cumulative Index to Nursing and Allied Health Literature, Embase, Medline and PubMed from 1 December 2019 to 12 May 2020 to harvest articles from medical journals and publications reporting cases of COVID-19 in neonates from anywhere in the world. Additional searches were also done so as not to miss any important publications. Write-up was in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, the protocol for the review was registered with International Prospective Register of Systematic Reviews (PROSPERO), and risk of bias was analysed with the Newcastle-Ottawa tool. Additionally, the preterm neonate with COVID-19 from our hospital is also reported.

Results The systematic review has revealed eight studies where neonates have been described to have confirmed COVID-19, with low risk of bias. Of the 10 reported cases elsewhere, only three are likely to be vertically transmitted, while seven occurred in the postperinatal period and are likely to have been postnatally acquired. All neonates had a mild course, recovered fully and were negative on retesting. Our case of COVID-19 in a 32-week premature baby from the UK was delivered by emergency caesarean section, with the mother wearing a face mask and the family having no contact with the neonate, suggesting vertical transmission. On day 33, the neonate was asymptomatic but was still RT-PCR-positive on nasopharyngeal airway swab.

Conclusions Neonatal infection is uncommon, with only two previously reported cases likely to be of vertical transmission. The case we report is still RT-PCR-positive on day 28 and is asymptomatic. Ongoing research is needed to ascertain the epidemiology of COVID-19 in neonates.

  • coronavirus
  • SARS-CoV-2
  • COVID-19
  • neonate
  • premature baby

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  • Twitter @drmorrisgordon, @drtaher

  • Contributors MG ant TK led the systematic review and manuscript drafting. KR, CR, MIA and AG cared for the neonate reported, contributed to the manuscript and approved the submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Next of kin consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.