{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T05:06:19Z","timestamp":1774155979297,"version":"3.50.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T00:00:00Z","timestamp":1614211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> We aimed to describe the presentations and biochemical characteristics of sepsis-like syndrome (SLS) in infants aged &amp;lt;2 months who tested positive for SARS-CoV-2-in comparison to those in the same age group who were SARS-CoV-2-negative.<\/jats:p><jats:p><jats:bold>Background:<\/jats:bold> COVID-19 presents with a spectrum of manifestations, and children seem to have a favorable clinical course compared to other age groups. Limited data are available for symptomatic infants.<\/jats:p><jats:p><jats:bold>Design:<\/jats:bold> This was a case-controlled single-institution retrospective study on infants aged &amp;lt;2 months admitted with SLS between 1 April 2020 and 1 July 2020. These infants were divided into 2 groups: Group 1 (<jats:italic>n<\/jats:italic> = 41), infants with positive nasal\/oropharyngeal swab polymerase chain reaction (PCR) results for SARS-CoV-2; and Group 2 (<jats:italic>n<\/jats:italic> = 40), infants with negative PCR results for SARS-CoV-2 (control group). Details between both groups were reviewed and analyzed.<\/jats:p><jats:p><jats:bold>Outcome:<\/jats:bold> The clinical and laboratory data for SARS-CoV-2 -positive infants who presented with SLS may differ from those for infants with SLS who tested negative for SARS-CoV-2.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Overall, 105 infants were admitted with clinical sepsis: 41 were SARS-CoV-2-positive, and 64 were negative. Fever was present in 90% of SARS-CoV-2-positive infants vs. 80% of the negative group. SARS-CoV-2-positive infants had a higher incidence of nasal congestion and cough (39 and 29%, respectively) compared to the SARS-CoV-2-negative group (20 and 3%, respectively) (<jats:italic>P<\/jats:italic> &amp;lt; 0.05). Poor feeding and hypoactivity occurred more frequently in the SARS-CoV-2-negative group (58 and 45%, respectively) than in the SARS-CoV-2-positive group (22 and 12%, respectively, <jats:italic>P<\/jats:italic> &amp;lt; 0.004). Sepsis workup, including lumbar puncture, was performed in 67% and partial septic workup was performed in 23% of the SARS-CoV-2-positive infants. Full sepsis workup was performed in 92% of the SARS-CoV-2-negative group. Cerebrospinal fluid (CSF) cultures were negative in 26\/27SARS-CoV-2-positive infants (an infant had <jats:italic>Klebsiella meningitis<\/jats:italic>). All the SARS-CoV-2-negative infants had negative CSF cultures. Blood culture was negative in both groups. Urine culture showed bacterial growth in 9 infants with SARS-CoV-2-negative sepsis.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Our study showed that respiratory symptoms (cough and nasal congestion) were more prominent in the SARS-CoV-2-positive group, while poor feeding and hypoactivity were reported more frequently in the negative group. However, the clinical differentiation between COVID-19 disease and sepsis in such age groups is difficult. Therefore, screening young infants with SLS for SARS-CoV-2- is necessary during this pandemic.<\/jats:p>","DOI":"10.3389\/fped.2021.634844","type":"journal-article","created":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T06:59:15Z","timestamp":1614236355000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":17,"title":["Neonates and Young Infants With COVID-19 Presented With Sepsis-Like Syndrome: A Retrospective Case Controlled Study"],"prefix":"10.3389","volume":"9","author":[{"given":"Manasik","family":"Hassan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Khalil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samar","family":"Magboul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ohood","family":"Alomari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tasneim","family":"Abdalla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hafez","family":"Alsliman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulla","family":"Alhothi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eman","family":"Al Maslamani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"AlAmri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashraf","family":"Soliman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,2,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.prrv.2020.06.006","article-title":"Covid-19 in pregnant women and babies: what pediatricians need to know","volume":"35","author":"Rozycki","year":"2020","journal-title":"Paediatr Respir Rev"},{"key":"B2","doi-asserted-by":"publisher","first-page":"104","DOI":"10.3389\/fped.2020.00104","article-title":"Infants born to mothers with a new coronavirus (COVID-19)","volume":"8","author":"Chen","year":"2020","journal-title":"Front Pediatr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e20200702","DOI":"10.1542\/peds.2020-0702","article-title":"Epidemiology of COVID-19 among children in China","volume":"145","author":"Dong","year":"2020","journal-title":"Pediatrics"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1663","DOI":"10.1056\/NEJMc2005073","article-title":"SARS-CoV-2 infection in children","volume":"382","author":"Lu","year":"2020","journal-title":"N Engl J Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"422","DOI":"10.15585\/mmwr.mm6914e4","article-title":"Coronavirus disease 2019 in children\u2013United States, february 12\u2013april 2, 2020","volume":"69","author":"CDC","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"B6","unstructured":"PruthiS\n          COVID-19 (Coronavirus) in Babies and Children"},{"key":"B7","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1093\/cid\/ciaa201","article-title":"A well infant with coronavirus disease 2019 with high viral load","volume":"71","author":"Kam","year":"2020","journal-title":"Clin Infect Dis"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1313","DOI":"10.1001\/jama.2020.2131","article-title":"Novel coronavirus infection in hospitalized infants under 1 year of age in China","volume":"323","author":"Wei","year":"2020","journal-title":"JAMA"},{"key":"B9","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1001\/jamapediatrics.2020.0878","article-title":"Neonatal early-onset infection with SARS-CoV-2 in 33 neonates born to mothers with COVID-19 in Wuhan, China","volume":"174","author":"Zeng","year":"2020","journal-title":"JAMA Pediatr"},{"key":"B10","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1007\/s12519-020-00345-5","article-title":"Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus","volume":"16","author":"Chen","year":"2020","journal-title":"World J Pediatr"},{"key":"B11","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1186\/s13052-020-0820-x","article-title":"Novel coronavirus disease (COVID-19) in newborns and infants: what we know so far","volume":"46","author":"De Rose","year":"2020","journal-title":"Ital J Pediatr"},{"key":"B12","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1016\/j.jfma.2020.02.009","article-title":"SARS-CoV-2 infection in children: transmission dynamics and clinical characteristics","volume":"119","author":"Cao","year":"2020","journal-title":"J Formos Med Assoc"},{"key":"B13","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"A novel coronavirus from patients with pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N Engl J Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1097\/INF.0000000000002660","article-title":"Coronavirus infections in children including COVID-19: an overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children","volume":"39","author":"Zimmermann","year":"2020","journal-title":"Pediatr Infect Dis J"},{"key":"B15","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1016\/S0140-6736(20)30211-7","article-title":"Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study","volume":"395","author":"Chen","year":"2020","journal-title":"Lancet"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1001\/jama.2020.1585","article-title":"Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China","volume":"323","author":"Wang","year":"2020","journal-title":"JAMA"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.1056\/NEJMoa2001316","article-title":"Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia","volume":"382","author":"Li","year":"2020","journal-title":"N Engl J Med"},{"key":"B18","unstructured":"CDC Details COVID-19-Related Inflammatory Syndrome in Children"},{"key":"B19","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1186\/s12931-020-01338-8","article-title":"Analysis of clinical characteristics and laboratory findings of 95 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a retrospective analysis","volume":"21","author":"Zhang","year":"2020","journal-title":"Respir Res"},{"key":"B20","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1016\/j.jmii.2020.02.012","article-title":"Asymptomatic carrier state, acute respiratory disease, and pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): facts and myths","volume":"53","author":"Lai","year":"2020","journal-title":"J Microbiol Immunol Infect"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1063","DOI":"10.1515\/cclm-2020-0240","article-title":"The critical role of laboratory medicine during coronavirus disease 2019 (COVID-19) and other viral outbreaks","volume":"58","author":"Lippi","year":"2020","journal-title":"Clin Chem Lab Med"},{"key":"B22","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.ijid.2020.04.027","article-title":"Specific ACE2 expression in small intestinal enterocytes may cause gastrointestinal symptoms and injury after 2019-nCoV infection","volume":"96","author":"Zhang","year":"2020","journal-title":"Int J Infect Dis"},{"key":"B23","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1186\/s12890-020-01286-5","article-title":"Chest x-ray findings and temporal lung changes in patients with COVID-19 pneumonia","volume":"20","author":"Rousan","year":"2020","journal-title":"BMC Pulm Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e20201550","DOI":"10.1542\/peds.2020-1550","article-title":"Novel coronavirus infection in febrile infants aged 60 days and younger","volume":"146","author":"McLaren","year":"2020","journal-title":"Pediatrics"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e20200961","DOI":"10.1542\/peds.2020-0961","article-title":"Coinfection and other clinical characteristics of COVID-19 in children","volume":"146","author":"Wu","year":"2020","journal-title":"Pediatrics"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e20182894","DOI":"10.1542\/peds.2018-2894","article-title":"Management of neonates born at \u226535 0\/7 weeks' gestation with suspected or proven early-onset bacterial sepsis","volume":"142","author":"Puopolo","year":"2018","journal-title":"Pediatrics"},{"key":"B27","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1007\/s40121-020-00324-3","article-title":"A Systematic Review of the Clinical Utility of Cycle Threshold Values in the Context of COVID-19","volume":"9","author":"Rao","year":"2020","journal-title":"Infect Dis Ther."}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2021.634844\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T06:59:38Z","timestamp":1614236378000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2021.634844\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,25]]},"references-count":27,"alternative-id":["10.3389\/fped.2021.634844"],"URL":"https:\/\/doi.org\/10.3389\/fped.2021.634844","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,25]]},"article-number":"634844"}}