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《Lancet，3月6日，Managing neonates with respiratory failure due to SARS-CoV-2 – Authors' reply》

  • 来源专题：COVID-19科研动态监测
  • 编译者： xuwenwhlib
  • 发布时间：2020-03-07

  • Managing neonates with respiratory failure due to SARS-CoV-2 – Authors' reply

    Jianhui Wang

    Yuan Shi

    Published:March 06, 2020DOI:https://doi.org/10.1016/S2352-4642(20)30072-9

    We thank Daniele De Luca for his reflections on our Comment.1 We agree that testing all admitted neonates for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not necessary. We recommended screening all newly admitted infants at high risk of coronavirus disease 2019 (COVID-19) on the basis of their family history. Only high-risk patients should receive a nucleic acid test for SARS-CoV-2. However, all high-risk neonates should be isolated in a single room, preferably in a neonatal intensive care unit (NICU). Based on existing experience, some patients initially present with mild flu-like symptoms but rapidly develop respiratory distress and multiple organ failure. Admitting all neonates with COVID-19 to the NICU could ensure the availability of close monitoring and necessary interventions.2 However, each clinical setting should consider its bed surge capacity in case of a COVID-19 outbreak and adopt a flexible and variable approach to admitting patients.

  • 原文来源：https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30072-9/fulltext
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  • 《Lancet，3月6日，Managing neonates with respiratory failure due to SARS-CoV-2》
    • 来源专题：COVID-19科研动态监测
    • 编译者：xuwenwhlib
    • 发布时间：2020-03-07
    • Managing neonates with respiratory failure due to SARS-CoV-2 Daniele De Luca Published:March 06, 2020DOI:https://doi.org/10.1016/S2352-4642(20)30073-0 In their Comment in The Lancet Child & Adolescent Health, Jianhui Wang and colleagues1 suggested a plan to handle neonates with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and outbreaks in neonatal intensive care units (NICUs). This is a timely reflection, given the public health problem represented by this infection and the need to anticipate any critical care issue, irrespective of patients' ages. However, the plan is incomplete or unsuitable in many points. We do not know anything about neonatal SARS-CoV-2 infections, and we must reasonably follow data from adult critical care. First, testing all NICU-admitted neonates for SARS-CoV-2 represents a wrongful use of resources. Neonatal respiratory failure can result from a wide range of causes, and testing everybody when other causes are reasonably suspected will divert laboratory resources from adult critical care. Tests should be done for infants from families infected by SARS-CoV-2 or exposed to other infected people, irrespective of their symptoms.
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  • 《LANCET，4月7日，Invisible spread of SARS-CoV-2 – Authors' reply》
    • 来源专题：COVID-19科研动态监测
    • 编译者：xuwenwhlib
    • 发布时间：2020-04-08
    • Invisible spread of SARS-CoV-2 – Authors' reply Adam J Kucharski Rosalind M Eggo Published:April 07, 2020DOI:https://doi.org/10.1016/S1473-3099(20)30275-9 We thank Nian Xiong and colleagues for their response to our Article.1 Although we separated individuals into exposed and infectious compartments in the basic model, we also considered a sensitivity analysis whereby people became infectious in the second half of their incubation period, and obtained the same conclusion (Article appendix p 12). We allowed the reproduction number, R, to vary over time in our model, rather than simply fix this value, to capture possible variation in transmission as a result of control measures and behaviour change. However, our median estimate for the reproduction number in mid-January of 2·4 is consistent with other estimates from the same period by use of a fixed R.2 As there is a delay from infection to symptom onset to hospitalisation, our model incorporated a delay to account for the time it takes for changes in transmission to be reflected in the observed data. Our estimate for transmission reduction was similar to that in another study, which focused on case counts in Wuhan and estimated that R had declined to around 1·3 by the last week of January, 2020.3 We disagree that our assumed incubation period was inappropriate; our assumption of a 5·2 day (SD 3·7) value is consistent with later studies that have estimated a similar value.4
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