A Contingency Plan for the Management of the 2019 Novel Coronavirus Outbreak in Neonatal …

Wang J, Qi H, Bao L, Li F, Shi Y; National Clinical Research Center for Child Health and Disorders and Pediatric Committee of Medical Association of Chinese People’s Liberation Army. A contingency plan for the management of the 2019 novel coronavirus outbreak in neonatal intensive care units. Lancet Child Adolesc Health. 2020 Apr;4(4):258-259. doi: 10.1016/S2352-4642(20)30040-7. Epub 2020 Feb.

Since December, 2019, a pneumonia of unknown cause, which has clinical manifestations similar to severe acute respiratory syndrome, originated in Wuhan, China, and has rapidly spread across China and to at least 23 countries. By Feb 5, 2020, the number of laboratory-confirmed cases had exceeded 20 000, with more than 400 deaths. About 100 children were affected, with the youngest being 30 h after birth. A novel virus named 2019 novel coronavirus (2019-nCoV) was considered to be the causative agent of this pneumonia. Neonates are thought to be susceptible to the virus because their immune system is not well developed, which is of great concern to neonatal medical service providers. Paediatricians and neonatologists belonging to the National Clinical Research Center for Child Health and Disorders and Pediatric Committee of Medical Association of Chinese People’s Liberation Army have contributed to the control efforts in China. We aim to elicit a contingency plan for the 2019-nCoV outbreak in neonatal intensive care units (NICUs), mainly focused on diagnostic and discharge criteria, treatment, prevention, and control strategies.

Most adults or children with 2019-nCoV infection presented with mild flu-like symptoms, although patients with severe illness could rapidly develop acute respiratory distress syndrome, respiratory failure, and multiple organ failure, and deaths have been reported in some cases. Most patients with pneumonia had abnormal chest radiography findings, such as bilateral ground-glass opacity, multiple lobular, and subsegmental areas of consolidation; those with acute respiratory distress syndrome could show bilateral complete opacification of the lungs on CT scans.1
Routine blood work was mostly unremarkable. The nucleic acid test from respiratory tract samples or serum is effective in detecting the virus, and results are usually available within 4–6 h.5

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