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.