Publication Date

Publication Type

https://pediatrics.aappublications.org/content/early/2020/05/12/peds.2020-1567?cct=2287

Clinical Features (of neonatal infection)

Based on the China experience, asymptomatic or minimally symptomatic infection in children appears to be common and is probably responsible for community spread. Children are less likely to present with fever. Co-infection with other respiratory virus is well documented. Children have similar findings on CXR/Chest CT but have milder illness overall.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/pediatric-hcp.html

meganjkirkley@gmail.com

Perinatal/Neonatal Transmission

Peer-Reviewed Article

Among the first confirmed cases, median age was 59 years and 56% were male.
The mean incubation period was 5.2 days with the 95th percentile at 12.5 days.
In early stages, the epidemic doubled in size every 7.4 days for a basic reproductive number estimated at 2.2.

https://www.nejm.org/doi/full/10.1056/NEJMoa2001316

susan.niermeyer@cuanschutz.edu

Perinatal/Neonatal Transmission

Expert Opinion / Letter to Editor

Counting the number of cases is necessary to calibrate the epidemic response.
Surveillance and cohort studies in well-defined settings/populations can help in describing the overall burden and the household and community attack rate.

https://www.nejm.org/doi/full/10.1056/NEJMp2002125

susan.niermeyer@cuanschutz.edu

Clinical Features (of neonatal infection)

Peer-Reviewed Article

Among the 10 neonates, 6 were premature and 4 term.
Neonates manifested shortness of breath, fever, thrombocytopenia and abnormal liver function as well as tachycardia, vomiting, pneumothorax.
Pharyngeal swabs collected from 9 neonates were all negative.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036645/pdf/tp-09-01-51.pdf

susan.niermeyer@cuanschutz.edu

Perinatal/Neonatal Transmission

Peer-Reviewed Article

Woman at 35 weeks gestation with positive sputum, but negative serum, urine, feces, amniotic fluid umbilical cord blood, placenta and breast milk.
Baby was delivered by C-section for FHR 110, sent to a negative-pressure ward, and oropharyngeal swab at birth negative for SARS-CoV-2.

susan.niermeyer@cuanschutz.edu

Perinatal/Neonatal Transmission

Peer-Reviewed Article

Comparison of pregnancy outcomes of 16 women with COVID-19 and 45 women without.
Mean gestational ages 38.7 and 37.9 wks and all deliveries were by Caesarean section.
There was no different in fetal distress, meconium-stained amniotic fluid, preterm birth, asphyxia; however, only 1 mother had severe disease.

https://doi.org/10.3760/cma.j.cn112141-20200218-00111

susan.niermeyer@cuanschutz.edu

Consensus Statement / General Review

Expert Opinion / Letter to Editor

https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-020-01533-w?utm_source=sn&utm_medium=referral&utm_content=null&utm_campaign=BSLB_4_CA01_GL_BSLB_USG_CA01_GL_LSGR_PubH_Coronavirus_LandingPage

clyde.wright@cuanschutz.edu

Clinical Features (of neonatal infection)

Peer-Reviewed Article

Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China

Case series from Wuhan Children's Hospital discussing 33 neonates born to COVID19 positive mothers. Of these, 3 patients were found to be COVID19 positive by day of 2 of life and all presented with lethargy and pneumonia; and 2 of the 3 presented with fever. These symptoms were mild and supportable and all 3 had "favorable" outcomes. Perhaps importantly, this data suggests that perinatal transmission is possible.

https://jamanetwork.com/journals/jamapediatrics/fullarticle/2763787?guestAccessKey=dc607cc9-7197-4cc2-8d64-25a5f3f3132b&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamapediatrics&utm_term=mostread&utm_content=olf-widget_03302020

clyde.wright@cuanchutz.edu

Consensus Statement / General Review

Expert Opinion / Letter to Editor

Consensus guidelines from 36 experts in 12 countries on management of adults with COVID. Guidelines on infection control, respiratory, cardiovascular, antibiotic/antiviral therapies are offered. Most to nearly all are of weak evidence level - and extrapolated from general sepsis/ARDS literature. Notably, steroids if intubated are recommended and convalescent plasma is NOT recommended at this point.

https://jamanetwork.com/journals/jama/fullarticle/2763879

CLYDE.WRIGHT@UCDENVER.EDU

Perinatal/Neonatal Transmission

Peer-Reviewed Article

Case series of 6 mother-infant dyads of infant antibody levels (IgG and IgM) born to COVID+mothers with pneumonia
Editorial of interest: https://jamanetwork.com/journals/jama/fullarticle/2763851

https://jamanetwork.com/journals/jama/fullarticle/2763854

CLYDE.WRIGHT@UCDENVER.EDU

Clinical Features (of neonatal infection)

Peer-Reviewed Article

Characterizes clinical manifestations of COVID+ pediatric patients. Letter to authors asks about whether routine vaccine schedule provides some protection and explains why children are protected (https://pediatrics.aappublications.org/content/early/2020/03/16/peds.2020-0702/tab-e-letters), authors reply they have no information on that issue.

https://pediatrics.aappublications.org/content/early/2020/03/16/peds.2020-0702/tab-article-info

CLYDE.WRIGHT@UCDENVER.EDU

Consensus Statement / General Review

Expert Opinion / Letter to Editor

https://pediatrics.aappublications.org/content/early/2020/03/16/peds.2020-0834

CLYDE.WRIGHT@UCDENVER.EDU

Perinatal/Neonatal Transmission

Peer-Reviewed Article

Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding

1) case series of 10 patients (2mo-15 yrs) and all diagnosed based on exposure history
2) Pediatric patients had limited respiratory symptoms, but had persistent fecal shedding (lasting longer than respiratory symptoms, and often without GI sx)
3) all patient treated with alpha-interferon tid; one tx with azithro and IVIG and kept in hospital until swabs negative!!

https://www.nature.com/articles/s41591-020-0817-4?utm_source=sn&utm_medium=referral&utm_content=RMarketing&utm_campaign=BSLB_4_CA01_GL_BSLB_USG_CA01_GL_LSGR_PubH_Coronavirus_LandingPage

CLYDE.WRIGHT@UCDENVER.EDU

Management & Therapeutics

Expert Opinion / Letter to Editor

https://dtb.bmj.com/content/early/2020/03/31/dtb.2020.000021

CLYDE.WRIGHT@UCDENVER.EDU

Management & Therapeutics

Expert Opinion / Letter to Editor

CLYDE.WRIGHT@UCDENVER.EDU

Management & Therapeutics

Expert Opinion / Letter to Editor

CLYDE.WRIGHT@UCDENVER.EDU

Management & Therapeutics

Expert Opinion / Letter to Editor

https://www.sciencedirect.com/science/article/pii/S0306987720304837

CLYDE.WRIGHT@UCDENVER.EDU

Clinical Features (of neonatal infection)

Expert Opinion / Letter to Editor

Renin-angiotensin system: The unexpected flaw inside the human immune system revealed by SARS-CoV-2

https://www.sciencedirect.com/science/article/pii/S0306987720304370

CLYDE.WRIGHT@UCDENVER.EDU

Perinatal/Neonatal Transmission

Expert Opinion / Letter to Editor

https://www.sciencedirect.com/science/article/pii/S0165037820300437

CLYDE.WRIGHT@UCDENVER.EDU

Management & Therapeutics

Expert Opinion / Letter to Editor

The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The Perspectives of clinical immunologists from China

Pertinent discussion on use of anti-inflammatories during COVID (logical extension to use during pregnancy for fetal lung maturity)

https://www.sciencedirect.com/science/article/pii/S1521661620301984

CLYDE.WRIGHT@UCDENVER.EDU

Clinical Features (of neonatal infection)

Expert Opinion / Letter to Editor

Potential Maternal and Infant Outcomes from Coronavirus 2019-nCoV (SARS-CoV-2) Infecting Pregnant Women: Lessons from SARS, MERS, and Other Human Coronavirus Infections

CLYDE.WRIGHT@UCDENVER.EDU

Clinical Features (of neonatal infection)

Peer-Reviewed Article

Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30176-6/fulltext

CLYDE.WRIGHT@UCDENVER.EDU

Perinatal/Neonatal Transmission

Peer-Reviewed Article

Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30360-3/fulltext

CLYDE.WRIGHT@UCDENVER.EDU

Clinical Features (of neonatal infection)

Peer-Reviewed Article

Clinical characteristics of novel coronavirus disease 2019 (COVID-19) in newborns, infants and children

https://www.pediatr-neonatol.com/article/S1875-9572(20)30026-7/fulltext

CLYDE.WRIGHT@UCDENVER.EDU

Consensus Statement / General Review

Expert Opinion / Letter to Editor

https://onlinelibrary.wiley.com/doi/full/10.1002/jmv.25740

CLYDE.WRIGHT@UCDENVER.EDU

Perinatal/Neonatal Transmission

Peer-Reviewed Article

An Analysis of 38 Pregnant Women with COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes.

https://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2020-0901-SA

CLYDE.WRIGHT@UCDENVER.EDU

Perinatal/Neonatal Transmission

Peer-Reviewed Article

Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis

https://www.ajronline.org/doi/full/10.2214/AJR.20.23072

CLYDE.WRIGHT@UCDENVER.EDU

Perinatal/Neonatal Transmission

Expert Opinion / Letter to Editor

https://www.ajog.org/article/S0002-9378(20)30197-6/fulltext

CLYDE.WRIGHT@UCDENVER.EDU

Perinatal/Neonatal Transmission

Peer-Reviewed Article

Detectable SARS‐CoV‐2 Viral RNA in Feces of Three Children during Recovery Period of COVID‐19 Pneumonia

Children with mild COVID infection all had positive throat swabs within 7 days, and positive viral RNA in stool by 10 days. Positive viral RNA in stool seems to persist at least a week after throat swabs negative.

https://onlinelibrary.wiley.com/doi/10.1002/jmv.25795

meganjkirkley@gmail.com

NICU-specific guidelines (PPE, DR practices, etc.)

virus detectable in aerosols for up to three hours, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel

https://www.nih.gov/news-events/news-releases/new-coronavirus-stable-hours-surfaces

meganjkirkley@gmail.com

Consensus Statement / General Review

Expert Opinion / Letter to Editor

Chinese expert consensus on the perinatal and neonatal management for the prevention and control of the 2019 novel coronavirus infection (First edition)

Old, but flow diagram on page 4 is nice outline of one option for managing positive mom, positive baby, or positive dyad.

meganjkirkley@gmail.com

Management & Therapeutics

Expert Opinion / Letter to Editor

1- patients (including children) with allergic rhinitis/atopy do not appear to have increased risk of morbidity/mortality, as opposed to adults with COPD/asthma
2- 40 pediatric patients with allergic rhinitis treated in Wuhan, 2/3 on intranasal steroids and 1/3 not- no difference in outcomes
3- recommendation: do not stop intranasal corticosteroids in patients at this time. While neonates infrequently are on intranasal CS, limited retrospective pediatric data supports the use of them will not worsen outcomes

https://onlinelibrary.wiley.com/doi/epdf/10.1111/all.14302

laura.sherlock@cuanschutz.edu

Management & Therapeutics

Expert Opinion / Letter to Editor

1- ribavirin shows direct antiviral effects on covid in vitro (Vero-RML6 and LLC-MK2 cells). Prior studied in SARS (2003- Canada and Hong Kong)- equivocal results even when in combo w steroids
2- ribavirin can be given aerosolized (has been used in RSV) or orally- for Covid has been suggested IV or oral (S/E hemolysis, anemia, hyperbili)
3- cost for manufacturing in the US is reportedly $0.2-2.1 per gram

https://onlinelibrary.wiley.com/doi/epdf/10.1002/jmv.25798

laura.sherlock@cuanschutz.edu

NICU-specific guidelines (PPE, DR practices, etc.)

Expert Opinion / Letter to Editor

1.) suggested delivery room managment: neg pressure room, PPE
2.) suggests universal screening of all infants and Respiratory/GI/CV/temp issues could be presenting sign
3.) suggested for symptomatic babies: neg pressure room, full PPE from head to toe, discharge when afebrile x72hrs, PCR neg from NP swab x2

https://fn.bmj.com/content/early/2020/03/04/archdischild-2020-318996

satya.houin@childrenscolorado.org

Management & Therapeutics

Expert Opinion / Letter to Editor

Case description of vaginal delivery of COVID-19 positive mother, managed with mask on the patient, droplet and contact precautions, separation from the infant, feeding with pumped milk and formula, and discharge on day 6 (no re-testing of mother, no testing of infant) with both mother and baby clinically well.

https://www.nejm.org/doi/full/10.1056/NEJMc2007605?query=TOC

susan.niermeyer@cuanschutz.edu

Management & Therapeutics

Expert Opinion / Letter to Editor

1.) no data currently to discourage use of betamethasone. Therefore RECOMMENDS betamethasone in <34 weeks gestation
2.) discourages use of betamethasone in late preterm gestation 34+0 to 36+6 weeks

https://www.acog.org/clinical-information/physician-faqs/covid-19-faqs-for-ob-gyns-obstetrics

satya.houin@childrenscolorado.org

Perinatal/Neonatal Transmission

Peer-Reviewed Article

Turbulent gas clouds and respiratory pathogen emissions: potential implications for reducing transmission of COVID-19

The dichotomy of droplet vs. aerosol transmission may actually be a continuum of droplet sizes. Outstanding videos show the dynamics of cough and sneeze "semiballistic emission trajectories".

https://jamanetwork.com/journals/jama/article-abstract/2763852

susan.niermeyer@cuanschutz.edu

Consensus Statement / General Review

Expert Opinion / Letter to Editor

1) immune system differences, transfer of maternal Abs; 2) expression of ACE-2 receptor needed for SARS-Cov2 is different in children; 3) fecal evidence of disease/carrier state persists much longer than nasopharyngeal secretions

https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.15271

stephanie.bourque@childrenscolorado.org

NICU-specific guidelines (PPE, DR practices, etc.)

Peer-Reviewed Article

Low-cost cloth face masks may decrease transmission among the population. Washing and drying affect the filtering efficiency as do pore size, shape, clearance, and density.

susan.niermeyer@cuanschutz.edu

Consensus Statement / General Review

Peer-Reviewed Article

1) pediatric cases account for 1-5% of total cases; 2) common symptoms of fever/respiratory symptoms with decreased rates of severe pneumonia compared to adults; 3) pediatric cases less likely to have elevated inflammatory markers and leukopenia compared to adults

https://onlinelibrary.wiley.com/doi/abs/10.1111/apa.15270

stephanie.bourque@childrenscolorado.org

NICU-specific guidelines (PPE, DR practices, etc.)

https://www.youtube.com/watch?v=O45ZuFrBE9g&feature=youtu.be

stephanie.bourque@childrenscolorado.org

NICU-specific guidelines (PPE, DR practices, etc.)

COVID-19 Recommendations for Management of Pregnant Women an Neonates with Suspected or Confirmed COVID-19

https://www.obgyn.utoronto.ca/sites/default/files/toronto_region_covid_19_management_of_pregnant_women_and_neonates_with_suspected_or_confirmed_covid_march_17_2020.pdf

stephanie.bourque@childrenscolorado.org

Clinical Features (of neonatal infection)

Expert Opinion / Letter to Editor

First neonatal case in SPAIN. Appears postpartum trasmission, 1st RT-PCR test negative on day 7th in asymptomatic phase, turned positive on day 9th

https://www.analesdepediatria.org/es-pdf-S1695403320301302

CLYDE.WRIGHT@UCDENVER.EDU

Perinatal/Neonatal Transmission

Peer-Reviewed Article

An 34wk infant born in Wuhan, China was SARS-CoV-2 positive on RT-PCR and had IgG and IgM to SARS-CoV-2 were elevated in the infant. Vaginal secretions of the mother were negative for the virus, indicating likely in utero transmission.

https://jamanetwork.com/journals/jama/fullarticle/2763853

robert.dietz@cuanschutz.edu

Perinatal/Neonatal Transmission

Expert Opinion / Letter to Editor

Editorial preaching caution on proclaiming vertical transmission is possible based on first generation ELISA testing of SARS-CoV-2 IgG and IgM testing with relatively low specificity and sensitivity. As testing improves in quality and quantity, more evidence is needed when counseling expectant mothers who are positive for COVID-19.

https://jamanetwork.com/journals/jama/fullarticle/2763851

robert.dietz@cuanschutz.edu

Clinical Features (of neonatal infection)

Peer-Reviewed Article

https://jamanetwork.com/journals/jama/fullarticle/2761659

robert.dietz@cuanschutz.edu

NICU-specific guidelines (PPE, DR practices, etc.)

Expert Opinion / Letter to Editor

Need to consider 1)how to get around limitations on milk donors bringing milk, 2)implications of decreased touch/skin-to-skin time for NICU babies while restrictions on visitation and volunteers are in place.

https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30103-6/fulltext

meganjkirkley@gmail.com

Diagnosis & Testing

Expert Opinion / Letter to Editor

Public Health information series from ATS; great bullet points on what has been learned about disease in adults. Helpful reference list.

https://www.atsjournals.org/doi/pdf/10.1164/rccm.2020C1

CLYDE.WRIGHT@UCDENVER.EDU

Management & Therapeutics

https://www.nature.com/articles/d41591-020-00006-0

CLYDE.WRIGHT@UCDENVER.EDU

Clinical Features (of neonatal infection)

Expert Opinion / Letter to Editor

https://onlinelibrary.wiley.com/doi/10.1002/oby.22809

CLYDE.WRIGHT@UCDENVER.EDU

NICU-specific guidelines (PPE, DR practices, etc.)

Peer-Reviewed Article

Emergency cesarean section performed in a patient with confirmed severe acute respiratory syndrome Coronavirus-2: a case report

Cesarean section at term in a woman with COVID-19 and obstructed labor utilized a dedicated operating room, spinal anesthesia, and enhanced PPE for personnel. Mother and infant were cared for separately postnatally.

susan.niermeyer@cuanschutz.edu

Clinical Features (of neonatal infection)

Expert Opinion / Letter to Editor

https://onlinelibrary.wiley.com/doi/pdf/10.1111/tri.13611

CLYDE.WRIGHT@UCDENVER.EDU

NICU-specific guidelines (PPE, DR practices, etc.)

Peer-Reviewed Article

Obstetricians from across Europe offer suggestions on the rapid reorganization of physical spaces, workflow, and patient care (outpatient, imaging, antenatal, labor and delivery, postnatal units) in the face of the novel Coronavirus pandemic.

susan.niermeyer@cuanschutz.edu

Clinical Features (of neonatal infection)

Peer-Reviewed Article

A 15 do neonate was admitted with fever, lethargy, cutaneous mottling, and respiratory distress without cough. Mother had symptoms of COVID-19. The baby recovered with supportive care.

susan.niermeyer@cuanschutz.edu

Perinatal/Neonatal Transmission

Expert Opinion / Letter to Editor

Vertical Transmission of Coronavirus Disease 19 (COVID-19) from Infected Pregnant Mothers to Neonates: A Review

https://www.tandfonline.com/doi/full/10.1080/15513815.2020.1747120

CLYDE.WRIGHT@UCDENVER.EDU

NICU-specific guidelines (PPE, DR practices, etc.)

Expert Opinion / Letter to Editor

Temporary separation of a newborn from a symptomatic mother may be prudent, but the feeding of expressed breast milk should be encouraged.

https://journals.sagepub.com/doi/full/10.1177/0890334420917102

susan.niermeyer@cuanschutz.edu

NICU-specific guidelines (PPE, DR practices, etc.)

Peer-Reviewed Article

International perspectives concerning donor milk banking during the SARS-CoV-2 (COVID-19) pandemic

https://journals.sagepub.com/doi/full/10.1177/0890334420917661

susan.niermeyer@cuanschutz.edu

NICU-specific guidelines (PPE, DR practices, etc.)

Expert Opinion / Letter to Editor

https://downloads.aap.org/AAP/PDF/COVID%2019%20Initial%20Newborn%20Guidance.pdf

stephanie.bourque@childrenscolorado.org

Consensus Statement / General Review

Brief FAQs from AAP regarding delivery room PPE, neonatal testing, isolation from mothers and hospital discharge critiera

https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/faqs-management-of-infants-born-to-covid-19-mothers/

stephanie.bourque@childrenscolorado.org

NICU-specific guidelines (PPE, DR practices, etc.)

Online resources including Canadian provincial approaches to neonatal care, literature review and simulation videos for teams preparing to manage PUI/COVID+ patients

https://www.allthingsneonatal.com/canadian-covid-19-resources/

stephanie.bourque@childrenscolorado.org

Clinical Features (of neonatal infection)

Peer-Reviewed Article

Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study

Review of 36 children (mean age 3.5 years) with COVID-19. About half had moderate sx with evidence of PNA; the rest had mild symptoms or were asymptomatic. Leukopenia, fever, and elevated inflammatory markers were associated with more severe disease. All survived.

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30198-5/fulltext

meganjkirkley@gmail.com

NICU-specific guidelines (PPE, DR practices, etc.)

Expert Opinion / Letter to Editor

https://www.sciencedirect.com/science/article/pii/S2589933320300409

stephanie.bourque@childrenscolorado.org

Perinatal/Neonatal Transmission

Peer-Reviewed Article

Viral shedding can occur in the absence of symptoms and before symptom onset. Containment measures should account for presymptomatic transmission in contact tracing and prevention measures should address this potential.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6914e1.htm?s_cid=mm6914e1_w

susan.niermeyer@cuanschutz.edu

Perinatal/Neonatal Transmission

Expert Opinion / Letter to Editor

https://www.tandfonline.com/doi/pdf/10.1080/02786826.2020.1749229?needAccess=true

CLYDE.WRIGHT@UCDENVER.EDU

Consensus Statement / General Review

https://www.thoracic.org/about/ats-podcasts/international-perspective-on-the-pediatric-covid-experience.php

CLYDE.WRIGHT@UCDENVER.EDU

Management & Therapeutics

Expert Opinion / Letter to Editor

CLYDE.WRIGHT@UCDENVER.EDU

Perinatal/Neonatal Transmission

Peer-Reviewed Article

Review article (note published March 23)
1) Covid-19 in pregnant women associated with PTB, fetal distress, miscarriage but no evidence of infection in newborns.
2) Unlike SARS/MERS pregnant women do NOT seem to be at risk for more severe respiratory symptoms than non-pregnant adults.

meganjkirkley@gmail.com

Perinatal/Neonatal Transmission

Transmission potential of SARS-CoV-2 in viral shedding observed at the University of Nebraska Medical Center

[Release pre-peer-review] There is evidence that SARS-CoV-2 is shed into the environment as expired particles, during toileting (stool), and through contact with fomites. This supports disease spread through both direct (droplet and person-to-person) and indirect (contaminated objects and airborne) contact.

https://www.medrxiv.org/content/10.1101/2020.03.23.20039446v2

susan.niermeyer@cuanschutz.edu

Perinatal/Neonatal Transmission

Expert Opinion / Letter to Editor

Rapid expert consultation on the possibility of bioaerosol spread of SARS-CoV-2 for the COVID-19 pandemic

There is evidence for bioaerosol spread of SARS-CoV-2 with speaking, as well as aerosolization with nasal cannula use. Patient toilet facilities and PPE doffing sites also returned high yield of viral RNA. Infectivity of these isolates has not been well established.

https://www.nap.edu/catalog/25769/rapid-expert-consultation-on-the-possibility-of-bioaerosol-spread-of-sars-cov-2-for-the-covid-19-pandemic-april-1-2020

susan.niermeyer@cuanschutz.edu

Perinatal/Neonatal Transmission

Peer-Reviewed Article

https://science.sciencemag.org/content/early/2020/03/30/science.abb6936

CLYDE.WRIGHT@UCDENVER.EDU

Management & Therapeutics

Expert Opinion / Letter to Editor

COVID‐19: Interim Guidance on Management Pending Empirical Evidence. From an American Thoracic Society‐led International Task Force

ATS: Guidance on management of adults. Of note (and perhaps relevant to pregnancy? or the arguments surrounding their use with COVID19 infection) 67% voted against steroids.

https://www.thoracic.org/professionals/clinical-resources/disease-related-resources/covid-19-guidance.pdf

CLYDE.WRIGHT@UCDENVER.EDU

Management & Therapeutics

Expert Opinion / Letter to Editor

https://www.nejm.org/doi/full/10.1056/NEJMc2007589?query=featured_coronavirus

CLYDE.WRIGHT@UCDENVER.EDU

Management & Therapeutics

Expert Opinion / Letter to Editor

CLYDE.WRIGHT@UCDENVER.EDU

Perinatal/Neonatal Transmission

Peer-Reviewed Article

https://onlinelibrary.wiley.com/doi/10.1002/jmv.25825

CLYDE.WRIGHT@UCDENVER.EDU

Perinatal/Neonatal Transmission

Peer-Reviewed Article

The isolation period should be longer: Lesson from a child infected with SARS‐CoV‐2 in Chongqing, China

https://onlinelibrary.wiley.com/doi/10.1002/ppul.24763

CLYDE.WRIGHT@UCDENVER.EDU

Management & Therapeutics

Expert Opinion / Letter to Editor

https://onlinelibrary.wiley.com/doi/10.1002/ppul.24748

CLYDE.WRIGHT@UCDENVER.EDU

Diagnosis & Testing

1) SARS-CoV-2 spike protein is the most unique part of the virus; highly conserved, 75% similar to SARS(1).
2) As long as antibody test is to the spike protein (rather than to nucleocapsid or other viral proteins that may be similar to other coronaviruses) it should not cross-react with other coronaviruses.
3)Antibody tests being developed in China, Netherlands, San Diego

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30788-1/fulltext

meganjkirkley@gmail.com

Management & Therapeutics

1) Phase 1 trial of mrna-1273 developed by Moderna Inc (Cambridge, MA)
2) Enrolled 45 healthy adults at KP Seattle who will receive varying doses 28-days apart and be followed for 1 year.

https://www.nih.gov/news-events/news-releases/nih-clinical-trial-investigational-vaccine-covid-19-begins

meganjkirkley@gmail.com

Diagnosis & Testing

Expert Opinion / Letter to Editor

Neutrophil-to-Lymphocyte ratio and Lymphocyte-to-C-reactive protein ratio in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis

Meta-analysis of neurophil:lymphocyte ratio and lymphocyte:CRP ratio in severe COVID infections; increased NLR levels and low LCR levels reflecting an enhanced inflammatory process may suggest a poor prognosis

https://onlinelibrary.wiley.com/doi/epdf/10.1002/jmv.25819

stephanie.bourque@childrenscolorado.org

NICU-specific guidelines (PPE, DR practices, etc.)

Academy of Breastfeeding Medicine

stephanie.bourque@childrenscolorado.org

Diagnosis & Testing

Expert Opinion / Letter to Editor

1- Table 1 with estimated distance of maximal air dispersion distance, modeled in a 70 kg adult male. O2 by NC 5L = 100 cm. CPAP by oronasal mask and NIV by helmet were the least air contamination. Patient coughing through N95 mask spread up to 15 cm.
2- recommend water-resistent gowns, double sterile gloves, FFP masks (different than WHO guidelines)
3- shower and make sure to decontaminant your ears when you degown before going home

https://err.ersjournals.com/content/errev/29/155/200068.full.pdf

laura.sherlock@cuanschutz.edu

Management & Therapeutics

Expert Opinion / Letter to Editor

3CLpro inhibitors as a potential therapeutic option for COVID-19: available evidence and ongoing clinical trials

1- Protease inhibitors are considered a treatment option for Covid. the main covid19 proteinase is 3-chymotrypsin like protease. Therapeutics that inhibit the cleavage function of 3CLpro may inhibit viral replication
2- lopinavir and ritonavir show promising binding affinity to SARS-CoV by molecular dynamic simulation analysis
3- as of 4/2/20 there were 11 RCT and 1 non randomized trials for LPV/r in the US NLM

https://reader.elsevier.com/reader/sd/pii/S1043661820309798?token=20A0E8135A33FFDE573D74122AE3BB2FBC3343F5301B5126F19F383458C2EB549FC2EDC8F3D3094429892E8E5B08CF7F

laura.sherlock@cuanschutz.edu

Management & Therapeutics

Expert Opinion / Letter to Editor

1- doses being used/proposed are about 4-5 times higher (China) or 2x higher (France) than what is used for lupus. with prolonged use in SLE, retinal toxicity can develop. it is unknown if the higher doses will increase short term risk. This ophthalmologist doesn't think routine exams post use are needed at this point but suggests being aware
2- completely unknown what the impact on the developing retina would be, important in our population

https://www.ajo.com/article/S0002-9394(20)30132-X/pdf

laura.sherlock@cuanschutz.edu

Consensus Statement / General Review

Peer-Reviewed Article

susan.niermeyer@cuanschutz.edu

NICU-specific guidelines (PPE, DR practices, etc.)

Peer-Reviewed Article

Safe handling of containers of expressed human milk in all settings during the SARS-CoV-2 (COVID-19) pandemic

There is no evidence for virus in human milk. Breastfeeding or expressing milk requires close attention to infection prevention practices.

susan.niermeyer@cuanschutz.edu

NICU-specific guidelines (PPE, DR practices, etc.)

Peer-Reviewed Article

Recommendation about the perioperative prevention of infection to healthcare workers and the anesthesia management of children with SARS-CoV-2 infection

Detailed recommendations on intra/perioperative management of children and neonates from Zhejiang University .

susan.niermeyer@cuanschutz.edu

Management & Therapeutics

Peer-Reviewed Article

High-flow nasal oxygen offers potential advantages, including reduced need for intubation; however, concern over increased aerosolization of virus has restricted its use thus far.

susan.niermeyer@cuanschutz.edu

Perinatal/Neonatal Transmission

Peer-Reviewed Article

Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong

Despite intense concern over aerosol transmission, detailed analysis of staff/patient cohort suggests transmission can be prevented with basic infection control, such as surgical masks, hand and environmental hygiene.

susan.niermeyer@cuanschutz.edu

Perinatal/Neonatal Transmission

Peer-Reviewed Article

COVID-19 infection among asymptomatic and symptomatic pregnant women: Two weeks of confirmed presentations to an affiliated pair of New York City hospitals

Two week experience of 43 cases of COVID-19 positive pregnant women at Columbia; 24h testing of neonates with zero positive cases

https://els-jbs-prod-cdn.jbs.elsevierhealth.com/pb/assets/raw/Health%20Advance/journals/ymob/43_COVID_040320-1586192348270.pdf

stephanie.bourque@childrenscolorado.org

NICU-specific guidelines (PPE, DR practices, etc.)

Canadian Paediatric Society: Delivery room considerations for infants born to mothers with suspected or proven COVID-19

Updated CPS delivery room guidelines including: 1) Evaluation of common etiologies of respiratory distress (asides from COVID-19); 2) Neonatal attendance not routinely required for COVID-19 positive women in absence of other risk factors; 3) Continued practice of delayed cord clamping

https://www.cps.ca/en/documents/position/delivery-room-considerations-infants-born-to-mothers-with-suspected-or-proven-covid-19

stephanie.bourque@childrenscolorado.org

Clinical Features (of neonatal infection)

Peer-Reviewed Article

CDC COVID-19 Response Team,

This review of U.S. experience suggests that children may have typical symptoms or lack typical symptoms (e.g. cough and fever). Although hospitalized less frequently, they can have severe illness and die. Children should be regarded as having an important role in disease transmission; social distancing and preventive behaviors are important in all age groups.

susan.niermeyer@cuanschutz.edu

Consensus Statement / General Review

Peer-Reviewed Article

Review of factors affecting case numbers and health system utilization by epidemiologists and health economists.

susan.niermeyer@cuanschutz.edu

Clinical Features (of neonatal infection)

https://www.aappublications.org/news/2020/04/06/covidmmwr040620?cct=2287

laura.sherlock@cuanschutz.edu

Management & Therapeutics

Peer-Reviewed Article

susan.niermeyer@cuanschutz.edu

Management & Therapeutics

Peer-Reviewed Article

Case report of a woman with pre-eclampsia highlights the need for readily available testing to define etiology of symptoms and distinguish between viral symptoms and common complications of high-risk pregnancies.

susan.niermeyer@cuanschutz.edu

Clinical Features (of neonatal infection)

Peer-Reviewed Article

COVID-19 infection in a paucisymptomatic infant: Raising the index of suspicion in epidemic settings

A 32-day old boy presented with fever, rhinitis and cough but did not require oxygen and continued to breast feed. Such mildly symptomatic infants may be managed out of hospital, but can contribute to disease spread.

susan.niermeyer@cuanschutz.edu

Consensus Statement / General Review

Peer-Reviewed Article

Global interim guidance on coronavirus disease 2019 (COVID-19) during pregnancy and puerperium from FIGO and allied partners

susan.niermeyer@cuanschutz.edu

Clinical Features (of neonatal infection)

Peer-Reviewed Article

https://onlinelibrary.wiley.com/doi/10.1002/ppul.24762

CLYDE.WRIGHT@UCDENVER.EDU

Consensus Statement / General Review

Expert Opinion / Letter to Editor

This viewpoint provides a clinical update of COVID infections in the US, specifically on case fatality rate, testing, re-infection, and prevention (masks, social distancing, vaccines).

https://jamanetwork-com.proxy.hsl.ucdenver.edu/journals/jama/fullarticle/2764366

sunah.hwang@childrenscolorado.org