The frequency of detection of infected children with SARS-CoV-2, which is 10% of the total number of infected, including newborns, suggests the need for careful diagnosis of pathological conditions that may occur in children, particularly in the neonatal period. If at the beginning of the detection of COVID-19 it was claimed that the coronavirus SARS-CoV-2 does not affect children, then analyzing the new data we see that 2% of patients with diagnosed clinical cases of COVID-19 are children, including newborns. The article describes observations of several clinical cases of early neonatal adaptation of children born to women who had mild to severe COVID-19 during the first and third trimesters of pregnancy, respectively, because these children at birth had vesicular rash, symptom, which is considered rare for this category of newborns. In 2020, 2,300 newborns were born in the neonatal department of the 3rd City Clinical Hospital of Lviv, with every 5th woman in labor (20%) relapsed to COVID-19 during pregnancy.Analyzing the course of early neonatal adaptation, we found that the adaptation period of such children may not differ from the adaptation of newborns in the number and manifestations of transient conditions characteristic of the first days of life, whose mothers did not suffer from COVID-19 during pregnancy. However, coronavirus infection in women in both the first and third trimesters of pregnancy may be associated with signs of congenital vesiculosis in children, accompanied by inflammatory changes in the blood and blood clotting in the period of early neonatal adaptation in the newborn. Children had no other signs of pathological symptoms (fever, lethargy, drowsiness, hypotension, rhinorrhea, pharyngitis, cough, respiratory disorders (tachypnea, wheezing), vomiting, diarrhea and feeding disorders)), characteristic of infectious diseases specific to newborns, which can be masked by transient states. Manifestations of transient conditions in the observed children were: milia, simple erythema, desquamative peeling of the epidermis, toxic erythema, physiological jaundice.Treatment of the affected areas of the skin with rash elements with 0.05% aqueous solution of chlorhexidine, a three-day course of ampicillin, administered to the child from the first hours of life at a dose of 100 mg / kg / day intravenously contributed to the disappearance of vesiculosis. The maintenance therapy was a multiprobiotic in the form of drops. In the presented cases, no obstacles to breastfeeding and cohabitation of mother and child were observed. In the departments of newborn maternity hospitals, it is necessary to find opportunities, for diagnostic purposes, to conduct microbiological studies of pustules and biomaterial from the mucous membranes of the genital tract to further compare the results and establish etiological factors of vesiculosis, determine biochemical blood tests - CRP, ALT, AST, LD serum, coagulation parameters.
M. Kiselova, A. Komar, O. Malanchak
Neonatology, surgery and perinatal medicine