A new study has found that the prevalence of COVID-19 among infants could depend on the level of pandemic virus in the community.The study was published online in Pediatrics on June 30, 2012. It found that infants were more likely to contract the virus that causes COVID-19 infection. This is not because of COVID-19, but rather because they were being treated for a possible serious bacterial infection (SBI), during high COVID-19 levels in New York City. This study also showed that rates of COVID-19 positive in this age group were lower when there were low infection rates.Researchers from NYU Langone Health led the study. They also looked at the clinical course of COVID-19 in infants. The results showed that a fever was the most common manifestation of COVID-19."Enhancing our understanding of COVID-19 infection in young infants is important to inform clinical practice and plan public health measures like vaccination distribution," said Vanessa N. Raabe (MD), assistant professor in NYU Langone’s Departments of Medicine and Pediatrics in the Division of Pediatric Infectious diseasess and one of the principal investigators of the study.New York City was the epicenter of COVID-19, the United States' first epidemic. There were more than 190,000. Infected people in New York City during the peak of the NYC outbreak between March 2020 and May 2020. Children under 18 years old were responsible for three percent of all cases. However, these numbers could underestimate the true incidence due to the absence of proper testing. The majority of children who were infected with this disease were either asymptomatic or only mildly affected. There have been cases of severe illness reported, and reports indicate that young children may be more at risk than older ones for developing severe diseases.According to the study authors, young babies are frequently treated in hospital with antibiotics if they have a fever. Doctors then check for a more serious infection such as meningitis, or a bloodstream problem.Dr. Raabe says that fever is a common symptom for COVID-19 in children. Clinicians must consider COVID-19 as an underlying cause and not rely solely on imaging or laboratory results when deciding whether to test infants in hospitals for COVID-19.This study examined data from infants under 90 days old who were admitted to NYU Langone Health Hospitals and NYC Health + Hospitals/Bellevue Hospitals for SBI evaluation between March 2020 and December 2020. 15% of the 148 infants tested positive for COVID-19. Two infants with COVID-19 needed ICU admission but were safely discharged. The team discovered that only 3 per cent of infants were positive for COVID-19 during low community circulation periods, while 31 percent tested positive in areas with high infection rates.The study also showed that the incidence of other common viruses in hospitalized infants was only six percent. This is regardless of whether they were carrying COVID-19. Raabe says that this likely reflects a decrease in respiratory viruses in New York due to increased infection control practices like mask wearing and social distancing during the height of the pandemic.Researchers recommend that clinicians continue to evaluate young infants with fevers for bacterial infection, regardless of their COVID-19 status. This is because there are severe consequences if they are not treated.Michal Paret MD, lead author, is a fellow at NYU Langone's Department of Pediatrics, Division of Pediatric Infectious Diseases. "It may seem intuitive that what is occurring in children reflects the conditions in the surrounding communities, but it is reassuring to us that the evidence supports this relationship." The epidemiology of COVID-19 is constantly changing due to the emergence and implementation of vaccines. These changes require that physicians continue to study this age group in order to determine if a universal or selective testing strategy is best for the long-term health of infants.###To fully understand the impact of COVID-19 on this age group, additional research is required.Dr. Raabe, Dr. Paret and Dr. Raabe were also authors of the Pediatrics study: Gail F. Shust MD, Adam J. Ratner MD, Rebecca Pellet Madan MD, Jennifer L. Lighter MD, Asif Noor MD, Annum Jaffer MD, and Karim Lalani MD.Media inquiriesKatie UllmanTelephone: 212-404-3555Kathryn.ullman@nyulangone.org
