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Introduction: So far, no study has been conducted in Iran on the effect of COVID-19 on neonates. Therefore, the present cross-sectional study has been evaluated to determine the clinical manifestations and outcomes in neonates infected with COVID-19 in the west of Iran. Materials and Methods: The present cross-sectional study was conducted among neonates infected with COVID-19 in six provinces of Hamadan, Kermanshah, Kurdistan, Ilam, Zanjan and Lorestan, located in the west of Iran, from 1 March to 1 July 2020. In these neonates, the polymerase chain reaction test was positive. The data were collected by a checklist and were analysed using SPSS Statistics Software. Result: During the study period, 16 neonates infected with COVID-19 were identified including Kurdistan Province with five cases, Hamadan Province four cases, Kermanshah with three cases, and Lorestan and Zanjan provinces with two cases. Neonate gender of them had equal distribution. Two (15.38%) of them needed CPR after delivery. The delivery method for 9 (56.25%) was vaginal, and one of them died during the study period. The medical care used for these neonates was as follows: 87.5% were hospitalized in the intensive care unit and antibiotics were used for 68.75%. 12.5% underwent COVID-19-specific treatment, and for 25%, a ventilator was used. The laboratory findings in neonates infected with COVID-19 showed that in 18.75%, blood urea nitrogen has increased. 46.15% of neonates reported lymphocytopenia. The blood haematocrit and haemoglobin decreased by 31.35% and 56.25%, respectively. Conclusion: The coronavirus disease 2019 has occurred among neonates, but they seemed to have a milder disease course and better prognosis than adults. Findings showed that there is a possibility of vertical intrauterine transmission from pregnant mothers to newborns. [ABSTRACT FROM AUTHOR]