Mortality Risk Factors of Early Neonatal Sepsis During COVID-19 Pandemic

Svetlana I Kolesnichenko; Irina A Kadyrova; Alyona V Lavrinenko; Zhibek A Zhumadilova; Olga V Avdienko; Yelena V Vinogradskaya; Yevgeniy A Fominykh; Lyudmila G Panibratec; Lyudmila L Akhmaltdinova

doi:10.2147/IDR.S390723

Mortality Risk Factors of Early Neonatal Sepsis During COVID-19 Pandemic

Infect Drug Resist. 2022 Oct 31:15:6307-6316. doi: 10.2147/IDR.S390723. eCollection 2022.

Affiliations

¹ Shared Resource Laboratory, Research Centre, Karaganda Medical University, Karaganda, Kazakhstan.
² Regional Clinical Hospital of Karaganda, Perinatal Center No. 1, Karaganda, Kazakhstan.
³ Regional Clinical Hospital of Karaganda, Perinatal Center No. 2, Karaganda, Kazakhstan.
⁴ National Scientific Cardiac Surgery Center, Nur-Sultan, Kazakhstan.

^# Contributed equally.

Abstract

Purpose: This study aimed to determine predisposing factors for negative outcome in infants with early neonatal sepsis during COVID-19.

Patients and methods: A prospective cohort study of 172 newborns up to 4 days diagnosed with neonatal sepsis was carried out in Karaganda (Kazakhstan). The microbiological examination was used to identify a causative agent of bloodstream infection. ELISA was performed to determine the total anti-SARS-CoV-2 antibodies. Gestational age, mode of delivery, birth weight, C-reactive protein and procalcitonin levels, comorbidities, type of pathogen, duration of hospitalization and mother's infection diseases were used for statistical analysis.

Results: Mortality in infants with neonatal sepsis was 22% (38/172). Anti-SARS-CoV-2 antibodies were detected in 68.3% of the newborns. Culture-negative ELBW infants have a 5.3-fold higher risk of death (p<0.001). Low gestational age and a shorter period of hospitalization were statistically associated with fatality. CRP is generally higher in deceased children (p=0.002). Necrotizing enterocolitis (p<0.001), pneumonia (p=0.009) and anemia (p=0.016) were significantly associated with negative outcome. And, 31.4% of the infants with sepsis had positive blood cultures. The leading cause of sepsis in newborns was CoNS - 57%.

Conclusion: During COVID-19 pandemic neonatal sepsis mortality was associated with low birth weight, gestational age, and comorbidities as in non-pandemic time. The relationship between COVID-19 in the mother and neonatal mortality was not found. However, anti-SARS-CoV-2 antibodies were detected in more than half of newborns.

Keywords: COVID-19; coagulase-negative staphylococci; mortality; neonatal sepsis; preterm infants.

Grants and funding

This work was supported by the Science Committee of the Ministry of Education and Science of the Republic of Kazakhstan (grant no. AP08857386).