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Objective Since the global outbreak of the novel coronavirus disease 2019 (COVID-19), there have been increasing reports of children developing a croup-like cough associated with concurrent COVID-19 infection. Currently, there is not much information available regarding newborn infants and COVID-19 infection and the incidence of vertical transmission is thought to be rare. This novel case report depicts a term newborn infected at the time of birth with COVID-19 and includes details about the course of their complicated hospitalization. Study Design A term infant, found to be infected at birth with COVID-19, developed respiratory distress resulting in transfer to our neonatal intensive care unit. Due to the increasing respiratory support requirements, endotracheal intubation was required on day of life (DOL) 7. Later, when the infant was extubated, on DOL 21, a croup-like cough developed. Results Despite respiratory treatment with albuterol, budesonide, racemic epinephrine, lidocaine, dornase alfa, and a 10-day course of dexamethasone, the cough persisted. A prolonged hospitalization was required and eventually the infant was discharged home on 0.4 L/minute of oxygen via nasal cannula on DOL 95. Conclusion As the COVID-19 virus mutates over time, there are some seemingly different presentations in both the pediatric and adult populations. The hypervigilance and sharing of new findings among providers are paramount in the treatment of infants with COVID-19 disease. Key Points Term infant with COVID-19 developed a croup-like cough. Usual respiratory treatment not effective with croup-like cough and COVID-19. COVID-19 present at birth later requiring intubation. [ABSTRACT FROM AUTHOR]

Introduction  The long-term effects of prenatal coronavirus disease 2019 (COVID-19) infection on the fetal brain are mostly unknown at this time; however, there is increasing evidence being published. Case Report  Two cases of severe ventriculomegaly, neurological dysfunction, and seizures were found in neonates with prenatal exposure to COVID-19 infection during the first and third trimesters of pregnancy. Conclusion  Inflammation during the prenatal and neonatal periods may be associated with neurological disorders or injury. Despite the presumed lack of vertical transmission, post-COVID-19 syndrome and its associated inflammation may have an impact on the unborn fetus. Hyper-vigilance and dissemination of adverse findings are of significant importance as we navigate through this evolving pandemic and its effects. Key Points Prenatal exposure to COVID-19 may affect the fetal brain. There is a possibility of neonatal neurological sequelae from maternal COVID-19. Does maternal COVID-19 infection cause infantile seizures? [ABSTRACT FROM AUTHOR]

Background: Neonatal sepsis is a serious condition caused largely by group B Streptococcus (GBS), Escherichia coli (E. Coli), and Listeria monocytogenes. Prenatal screenings have decreased the incidence of GBS infections; however, it remains a leading cause of early-onset sepsis (EOS). Gram-positive organisms are often the cause of late-onset sepsis (LOS). While EOS is usually attributed to vertical transmission from mother to infant, LOS is secondary to pathogen exposure during delivery or hospi-talization. We sought to identify the prevalent organisms in positive blood cultures in our NICU. Methods: A retrospective chart review was completed from July 2009 to December 2019. If an organism was identified, a positive culture was included, and five or more days of antibiotics were administered. Infection occurring in the first three days of life was considered EOS, while LOS was any time after. Variables were evaluated using Fisher's exact and Wilcoxon rank-sum tests. Results: Over ten years, there were 89 positive blood cultures. Of these, 28% of the cases were EOS, and 72% were LOS. Interestingly, the median birth weight for infants with EOS was significantly larger at 1810g compared to 1021g for LOS (P=0.004). The median gestational age for EOS cases was 31 5/7 weeks compared to 27 2/7 weeks for LOS (P=0.086). Conclusions: Approximately half of EOS-causing organisms were GBS or E.Coli. Coagulase-negative staphylococcus and methicillin-susceptible Staphylococcus aureus were most prevalent in LOS. [ABSTRACT FROM AUTHOR]