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.