Incidence Rates of Medically Attended COVID-19 in Infants Less Than 6 Months of Age

Authors

Isabel Griffin
Stephanie A Irving
Carmen Sofia Arriola
Angela P Campbell
De-Kun Li
Fatimah S Dawood
Caroline Doughty-Skierski
Jeannette R Ferber
Nickolas Ferguson
Louise Hadden
Jillian T Henderson
Mary Juergens
Venkatesh Kancharla
Allison L Naleway
Gabriella Newes-Adeyi
Erin Nicholson
Roxana Odouli
Lawrence Reichle
Mo Sanyang
Kate Woodworth
Flor M Munoz

Publication Date

4-1-2023

Journal

The Pediatric Infectious Disease Journal

DOI

10.1097/INF.0000000000003823

PMID

36602338

PMCID

PMC9990480

PubMedCentral® Posted Date

1-5-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Pregnancy, Child, Infant, Humans, Female, Adolescent, Infant, Newborn, COVID-19, Incidence, SARS-CoV-2, COVID-19 Testing, Risk Factors, Pregnancy Complications, Infectious, COVID-19, coronavirus disease 2019, SARS-CoV-2, infants

Abstract

BACKGROUND: Studies suggest infants may be at increased risk of severe coronavirus disease 2019 (COVID-19) relative to older children, but few data exist regarding the incidence of COVID-19 episodes and associated risk factors. We estimate incidence rates and describe characteristics associated with medically attended COVID-19 episodes among infants younger than 6 months of age.

METHODS: We analyzed electronic medical record data from a cohort of infants born March 1, 2020-February 28, 2021. Data from 3 health care delivery systems included demographic characteristics, maternal and infant outpatient visit and hospitalization diagnoses and severe acute respiratory syndrome coronavirus syndrome 2 (SARS-CoV-2) test results. Medically attended COVID-19 episodes were defined by positive SARS-CoV-2 clinical tests and/or COVID-19 diagnosis codes during medical care visits. Unadjusted and site-adjusted incidence rates by infant month of age, low and high SARS-CoV-2 circulation periods and maternal COVID-19 diagnosis were calculated.

RESULTS: Among 18,192 infantssystems, 173 (1.0%) had medically attended COVID-19 episodes. Incidence rates were highest among infants under 1 month of age (2.0 per 1000 person-weeks) and 1 month (2.0 per 1000 person-weeks) compared with older infants. Incidence rates were also higher for infants born to women with postpartum COVID-19 compared with women without known COVID-19 and women diagnosed with COVID-19 during pregnancy.

CONCLUSIONS: Infants of women with postpartum COVID-19 had a higher risk of medically attended COVID-19 than infants born to mothers who were diagnosed during pregnancy or never diagnosed underscoring the importance of COVID-19 prevention measures for their household members and caregivers to prevent infections in infants.