Fetal growth and hemodynamics during SARS-CoV-2 infection: a short literature review

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a virus that, having crossed species, has caused human disease from 2019 - COrona Virus Disease 2019 (COVID-19). Pregnant women are potentially at high risk of contracting SARS-CoV-2 infection when compared to non-pregnant matched controls. Pregnancy is also complicated with a higher risk of developing severe SARS-CoV-2, including respiratory diseases, admission to the intensive care unit and mortality, even after adjusting for confounding risk factors. Moreover, data on the effect on fetal outcome including preterm delivery and perinatal morbidity are still conflicting, the risk of vertical transmission (i.e., transmission of SARS-CoV-2 from the mother to the fetus or the newborn) is considered low but there is evidence that a significant proportion of placentas where SARS-CoV-2 occurred during pregnancy show histopathological findings suggesting placental hypoperfusion and inflammation. In this review we will present the available data on the effects of SARS-CoV-2 infection on fetal growth and maternal hemodynamics

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Clinical profile of neonates with acute renal injury in neonatal intensive care unit at GMERS Medical College and General Hospital, Gotri, Vadodara, Gujarat, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20192000 ◽

2019 ◽

Vol 6 (3) ◽

pp. 1136

Author(s):

Kajal Lakhubhai Katariya ◽

Nimisha K. Pandya

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

High Risk ◽

Neonatal Intensive Care Unit ◽

General Hospital ◽

Neonatal Intensive Care ◽

Birth Asphyxia ◽

Female Ratio ◽

Medical College

Background: Acute kidney injury (AKI) is defined as an acute deterioration in ability of the kidneys to maintain homeostasis of body fluids and electrolytes leading to retention of wasted and toxic metabolic end products. It is fairly common in newborn population and is a major contributor of neonatal mortality and morbidity. The aim was to study the incidence of renal failure in high risk neonates and risk factors for renal failure.Methods: A prospective observational study was done to evaluate renal profile in high risk neonates admitted to neonatal intensive care unit, GMERS Medical College and General Hospital, Gotri, Vadodara, Gujarat, India over a 1-year period. nRifle criteria was used for classification of acute kidney injury.Results: The incidence of AKI in high risk newborns admitted in this study was 52 (37.14%). The male to female ratio in current study was 2.46:1. Majority of neonates with AKI were out born 44 (84.6%). The incidence of AKI was higher in term newborns. Mean weight in AKI group was 2048 grams. The highest incidence of AKI was found in AFD newborns (57.69%). nRifle criteria was used to diagnose AKI in this study. Out of 52 neonates who had AKI, 27 (51.9%) were in risk category, 21 (40.4%) were in injury group and 4 (7.7%) were in failure group. Mortality in these groups were 5 (18.51%), 7 (33.33%) and 3 (75%) respectively. Highest correlation of risk factors for AKI was found with birth asphyxia 18 (34.9%) followed by sepsis 12 (23.1%) and shock 15 (28.5%). 29 (55.76%) neonates had non oliguric AKI. 28 (53.8%) neonates with AKI developed dyselectrolytemia.Conclusions: Early recognition and management of risk factors can help in reducing the occurrence and improve outcomes in them.

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Targeting Risk Factors for the Control of Central Line-Associated Bloodstream Infection in the Neonatal Intensive Care Unit: A Single Tertiary Center Experience

Neonatal Medicine ◽

10.5385/nm.2021.28.3.116 ◽

2021 ◽

Vol 28 (3) ◽

pp. 116-123

Author(s):

Jiyoon Jeong ◽

Yoojin Kwun ◽

Min-ju Kim ◽

Sang-Ho Choi ◽

Euiseok Jung ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

High Risk ◽

Infection Control ◽

Neonatal Intensive Care Unit ◽

Bloodstream Infection ◽

Neonatal Intensive Care ◽

Central Line ◽

High Risk Infants

Purpose: The aim of this study was to estimate the effect of targeting risk factors for the control of central line-associated bloodstream infection (CLABSI) among high-risk infants in a tertiary neonatal intensive care unit (NICU).Methods: Infants admitted to the NICU and diagnosed with CLABSI from January to December 2013 were eligible for inclusion to the study. The CLABSI group (n=47) was matched in a 1:2 ratio to the control group (n=94) based on gestational age, birth weight, and Score for Neonatal Acute Physiology-II. Risk factors for CLABSI were identified using the Cox proportional hazard model, and analysis of the effect of these risk factors targeting infection control was performed.Results: The risk factors associated with CLABSI were prolonged central line dwell days (adjusted hazard ratio [HR], 1.028; 95% confidence interval [CI], 1.011 to 1.045; P=0.001), use of a silicone catheter (adjusted HR, 5.895; 95% CI, 1.893 to 18.355; P=0.002), surgical treatment (adjusted HR, 3.793; 95% CI, 1.467 to 9.805; P=0.006), and less probiotic supplementation (adjusted HR, 0.254; 95% CI, 0.068 to 0.949; P=0.042). By targeting these risk factors with a quality improvement initiative, the mean CLABSI incidence rate per 1,000 catheter-days decreased from 6.6 to 3.1 (P=0.004).Conclusion: Targeting risk factors for infection control significantly reduced the rate of CLABSI among high-risk infants in the NICU.

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Risk Factors of Respiratory Diseases Among Neonates in Neonatal Intensive Care Unit of Qena University Hospital, Egypt

Annals of Global Health ◽

10.5334/aogh.2739 ◽

2020 ◽

Vol 86 (1) ◽

Author(s):

Khaled A. Abdel Baseer ◽

Mostafa Mohamed ◽

Eman A. Abd-Elmawgood

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Respiratory Diseases ◽

University Hospital

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Clinical Characteristics, Risk Factors, and Outcomes of Patients with Polymicrobial Klebsiella pneumoniae Bloodstream Infections

BioMed Research International ◽

10.1155/2021/6619911 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Feizhen Song ◽

Kai Zhang ◽

Jianjiang Huang ◽

Zhenhua Qian ◽

Hongwei Zhou ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Klebsiella Pneumoniae ◽

Clinical Characteristics ◽

Significant Proportion ◽

Severity Of Illness ◽

Bloodstream Infections ◽

Poor Outcomes ◽

Hospital Days

Background. Polymicrobial Klebsiella pneumoniae bloodstream infection (KP-BSI) has been reported to account for more than 10% of all KP-BSI, but few studies have characterized polymicrobial KP-BSI. Our study investigated the clinical characteristics, risk factors, and outcomes of polymicrobial KP-BSI by comparing with monomicrobial KP-BSI. Methods. We conducted a single-center retrospective cohort study of patients with KP-BSI from 1 January 2013 to 31 December 2018 and collected the clinical data by reviewing electronic medical records. Results. Of the 818 patients with KP-BSI recruited, 13.9% (114/818) were polymicrobial KP-BSI. The severity of illness in polymicrobial and monomicrobial KP-BSI was similar, while the rate of resistance to carbapenems was obviously higher in polymicrobial KP-BSI (78.1% vs. 65.6%, p = 0.009 ). On multivariate analysis, hospitalization in burn ward (odds ratio (OR) 6.13, 95% confidence interval (CI) 2.00-18.76, p = 0.001 ) and intensive care unit (OR 2.39, 95% CI 1.05-5.43, p = 0.038 ) was independently associated with polymicrobial KP-BSI. Gram-negative bacteria accounted for the highest proportion (68.9%) among copathogens of polymicrobial KP-BSI, whereas gram-positive bacteria (22.9%) and Candida (8.2%) ranked the second and the third, respectively, with Acinetobacter baumannii being the most common (23.0%). Patients with polymicrobial KP-BSI had longer hospital days after BSI onset and total hospital days than patients with monomicrobial KP-BSI (median (interquartile range (IQR)), 19 (5, 39) vs. 12 (6, 25), 37 (21, 67) vs. 29 (16, 53), respectively, p < 0.05 ). The mortality did not differ between polymicrobial KP-BSI and monomicrobial KP-BSI (all p > 0.05 ). Conclusions. It was observed that polymicrobial KP-BSI accounted for a significant proportion among all KP-BSI in the current study. Hospitalization in burn ward and intensive care unit was an independent risk factor for the development of polymicrobial KP-BSI. The patients with polymicrobial KP-BSI had a higher rate of carbapenem-resistant K. pneumoniae and might have poor outcomes compared to monomicrobial KP-BSI.

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