Abstract

Introduction

Long-term lung function impairment after COVID-19 infection has been shown in adults, but not confirmed in children. As alveolarization develops in early childhood, we aimed to assess potential consequences of neonatal COVID-19 infection.

Methods

Prospective multicentre study. Inclusion criteria: COVID-19 infection in the first 4 weeks of life. Exclusion criteria: malformations, no informed consent. Lung function tests were programmed twice between 6 months and 2 years of life. Tidal breathing flow volume loop (TB) and multiple-breath nitrogen washout (MBNW) were performed using the Exhalyzer D during spontaneous sleep according to current guidelines. Variables were compared to published normal values for age at test.

Results

We studied 10 term-born children (3 were tested twice). None had neonatal respiratory issues related to COVID-19 infection; 2/10 had COVID-19 twice.

Median age at 1st test: 7 months (2 were assessed at 2 years). Median age at 2nd test: 11 months; 1/10 had wheezing 1 month before the first test, 2/3 had wheezing before the 2nd test. At 1st test all TB and 4/10 MBNW tests were acceptable; at 2nd test all TB and 2/3 MBNW tests were acceptable.

1st test 2nd test
Abnormal TV,n 3/10 1/3
Tidal volume(ml/kg), mean(SD) 11 (1.3) 9 (2.65)
Abnormal RR,n  1/10 1/3
Abnormal tPTEF/tE,n

4/10

1/3
tPTEF/tE ratio,mean(SD) 30.6 (7.7) 31.4 (10.9)
Abnormal FRC,n 0/4 0/2
Abnormal LCI5,n 3/4 1/2
LCI5,mean(SD) 7.81 (1.46) 7.57 (1.68)
Abnormal LCI2.5,n 4/4 2/2
LCI2.5,mean(SD) 8.63 (0.32) 8.71 (1.70)

             

Conclusions

In our population, neonatal COVID-19 infection along with other factors might be associated with altered indices of lung function at follow up.