EXCLUSION CRITERIA
Neonates in which SARS-CoV-2 antibodies were present but the clinical
presentation was not suggestive of multisystem nature were excluded.
Methodology: Cohort of MISN cases was subdivided based on the
timing of presentation , to differentiate the possible source of SARS-
CoV-2antibodies:
1. Early MISN (within 1st 72 h of life) — hypothesized as
presenting due to transplacental transfer of maternal
SARS-CoV-2antibodies.
2. Late MISN (more than 72 h of life) — hypothesized as
occurring either due to antibodies produced secondary to
SARS-CoV-2infection in the new born or transplacental transfer of
maternal SARS-CoV-2 antibodies.
The following data was collected in reported cases in pre-defined
structured proforma:
- Birth gestation, weight, etc.
- Serology: maternal and neonatal Serology for SARS- CoV-2 — both
antigen and antibodies to ascertain the mode of transmission
- Clinical features and laboratory results
- Management and outcomes
Age-specific normal ranges were used for analysis of laboratory
investigations. Deranged values were defined as serum Ferritin values
of>260ng/ml in term newborn and >200ng/ml in
preterm [23], D-dimer>2000ng/ml, ProB-type natriuretic
peptide (pro-BNP)>700pg/ml, and serum lactate dehydrogenase
>450U/l [24]. Echocardiogram (ECHO) was performed to
look for abnormal coronary dilatation and cardiac
dysfunction/contractility. Cardiac dysfunction or myocarditis on ECHO
was considered when left ventricular (LV) ejection fraction (EF) is
decreased <55% and fractional shortening (FS) <26%
on functional echocardiography [25]. Parental consent was obtained
from each case. Institutional Ethics committee, approval was taken.