Neurodevelopmental Outcomes of Infants Diagnosed with COVID-19: A Prospective Cohort Study

Abstract

Background: Neonatal infections, whether viral or bacterial, have been linked to adverse neurodevelopmental outcomes. Recent concerns regarding COVID-19 include its potential direct and indirect effects on the developing neonatal brain after infection. Objectives: We conducted a study to compare neurodevelopmental outcomes in infants with SARS-CoV-2 infection versus those with sepsis. Methods: A prospective cohort study was conducted to follow infants under 3 months with confirmed sepsis and SARS-CoV-2 infection admitted to the Children's Medical Center NICU between March 2020 and March 2023. Neurodevelopmental status was assessed using the Ages and Stages Questionnaire (ASQ). ANOVA analysis was employed to test for differences in the attainment of developmental milestones, adjusting for relevant clinical covariates such as birth weight and gestational age. Results: Infants with COVID-19 exhibited significant delays in communication and gross motor skills (P < 0.05), while fine motor and problem-solving skills did not differ substantially from those with sepsis. Despite the statistical difference in communication and gross motor domain scores, all children in the COVID-19 and sepsis groups remained at or above the ASQ "monitor" threshold. Subgroup analyses indicated that factors such as prematurity, hospital stay, and the need for respiratory support were associated with higher delays in communication and gross motor function in the COVID-19 group. Conclusions: Viral infections in infants, even when presenting with fewer clinical signs than bacterial sepsis, can lead to greater neurodevelopmental delays. Therefore, prevention is the cornerstone of treatment.