METHODS:
This study was conducted in Level IIIA NICU of BLDE (DU), Shri B M Patil Medical College, Hospital and Research Centre, Vijayapura from North Karnataka, Southern INDIA, between July 2020 and May 2021. A cohort of newborns presenting with multi-system involvement, along with the presence of SARS-CoV2 antibodies, was identified and enrolled in the study. Treating intensivists followed clinical protocols and management guidelines published by joint recommendation from the Federation of Obstetric and Gynecological Societies of India (FOGSI), National Neonatology Forum of India (NNF), and Indian Academy of Pediatrics (IAP) [18, 19]. These guidelines were adapted from the Indian Council of Medical Research (ICMR) protocol June 2020 which was based on the World Health Organization (WHO)/Centre for Disease Control (CDC) guidelines.
SARS-CoV2 antigens testing was done using the real-time polymerase chain reaction (RTPCR) method for nasopharyngeal swabs and SARS-CoV2 immunoglobulins were tested on Roche Cubase411 by ECLIA method in both maternal and neonatal blood samples. This method detects total number of antibodies against SARS-CoV-2, levels > 1.00 S/CO index were considered positive. The baseline investigations include complete blood count (CBC), C-reactive protein (CRP), D-dimer and coagulation profile in all cases, Serum Ferritin was monitored when a suspicion of cytokine storm arises. In cardiac involvement cases, lactate dehydrogenase (LDH), Pro B-type natriuretic peptide (proBNP) were done to assess myocardial dysfunction, and also echocardiography (ECHO) was done. Immunomodulator therapy was based on above mentioned guidelines and recommendations.