{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:40:55Z","timestamp":1753879255990,"version":"3.41.2"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T00:00:00Z","timestamp":1687824000000},"content-version":"vor","delay-in-days":177,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study aimed to describe the clinical characteristics and severity of young infants hospitalized with COVID\u201019 and study the relationship between breastfeeding and maternal COVID\u201019 vaccination on the severity of COVID\u201019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective, observational study was performed among infants aged 6\u2009months and below hospitalized for COVID\u201019 in a tertiary state hospital in Malaysia between February 1 and April 30, 2022. The primary outcome was \u201cserious disease,\u201d defined as pneumonia requiring respiratory support or dehydration with warning signs. Multivariate logistic regression was used to determine independent predictors for serious disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 102 infants were included in the study; 53.9% were males with a median age of 11\u2009weeks (interquartile range: 5\u201320\u2009weeks). Sixteen patients (15.7%) had pre\u2010existing comorbidities, including preterm birth. Fever was the most common presenting symptom (82.4%), followed by cough (53.9%), and rhinorrhea (31.4%). Forty\u2010one infants (40.2%) presented with serious disease, warranting either respiratory support or intravenous fluid therapy for dehydration. Recent maternal COVID\u201019 vaccination was associated with a reduced risk of serious disease on univariate analysis but was not significant after multivariate adjustment (adjusted odds ratio [aOR] 0.39; 95% CI: 0.14\u20131.11; <jats:italic>p<\/jats:italic>\u2009=\u20090.08). Exclusive breastfeeding was protective against serious COVID\u201019 in young infants, independent of other confounding factors (aOR 0.21, 95% CI: 0.06\u20130.71; <jats:italic>p<\/jats:italic>\u2009=\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>COVID\u201019 is a serious disease with non\u2010specific clinical manifestations in young infants. Exclusive breastfeeding could play an important protective role.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.15565","type":"journal-article","created":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T16:23:56Z","timestamp":1687883036000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics of <scp>COVID<\/scp>\u201019 in hospitalized young infants and risk factors for disease severity"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9665-3054","authenticated-orcid":false,"given":"David Chun\u2010Ern","family":"Ng","sequence":"first","affiliation":[{"name":"Department of Pediatrics Hospital Tuanku Ja'afar Seremban  Seremban Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8445-5816","authenticated-orcid":false,"given":"Kah Kee","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Perdana University\u2010Royal College of Surgeons in Ireland School of Medicine  Seremban Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8775-0303","authenticated-orcid":false,"given":"Chuin Hen","family":"Liew","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Hospital Tuanku Ampuan Najihah Kuala Pilah  Kuala Pilah Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yik Wan","family":"Low","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Hospital Tuanku Ja'afar Seremban  Seremban Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6591-8483","authenticated-orcid":false,"given":"Ling","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Hospital Tuanku Ja'afar Seremban  Seremban Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munzir Bin","family":"Jamil","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Hospital Tuanku Ja'afar Seremban  Seremban Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debashini a\/p","family":"Chandirasekharan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Hospital Tuanku Ja'afar Seremban  Seremban Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suhaila Binti","family":"Baharuddin","sequence":"additional","affiliation":[{"name":"Microbiology Unit, Department of Pathology Hospital Tuanku Ja'afar Seremban  Seremban Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5970-6948","authenticated-orcid":false,"given":"Yee Keat","family":"Cheah","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Hospital Tuanku Ja'afar Seremban  Seremban Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,27]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"1033","article-title":"Clinical prediction models for young febrile infants at the emergency department: an international validation study","volume":"103","author":"Vos\u2010Kerkhof E","year":"2018","journal-title":"Arch Dis Child"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-020-03683-8"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-0702"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000003435"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2021.100492"},{"issue":"303","key":"e_1_2_11_7_1","first-page":"e1","article-title":"Coronavirus disease 2019 vaccine response in pregnant and lactating women: a cohort study","volume":"225","author":"Gray KJ","year":"2021","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_11_8_1","unstructured":"MalaysiaMH.Management of Suspected Probable and Confirmed COVID\u201019.2022.https:\/\/covid\u201019.moh.gov.my\/garis\u2010panduan\/garis\u2010panduan\u2010kkm\/ANNEX\u20102E\u2010CLINICAL\u2010MANAGEMENT\u2010OF\u2010CONFIRMED\u2010COVID\u201019\u201031052022.pdf. 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