Community acquired RSV pneumonia in term newborns following relaxation in COVID appropriate behavior

Objectives: To study the profile of community acquired pneumonia in term newborns during an RSV epidemic following relaxation in CoVID appropriate behavior.. Design: A retrospective descriptive observational study based on review of hospital records over a one month period. Setting: Neonatology division of a tertiary care pediatric hospital, Kashmir ,India Participants: Neonates from 7 days upto 28 days of life. Results: Out of total 480 neonatal admissions over a month during an RSV outbreak 35 (7%) had community acquired pneumonia. Eight neonates were excluded. Out of 27 included neonates 13 were male. Mean age of presentation was 20 days (R=8-28 days).All babies were born at term.Mean weight was 3.1kgs. Cough in 26, Rapid breatning in 20 and lower chest indrawing in 20 newborns were the predominant presenting features. Fever was present in only 3. Median SPO2 was 87% (R=30-97%). Fourteen (52%) neonates needed admission to intensive care ward (NICU). Twenty four (89%) neonates needed respiratory support in the form of oxygen by prongs,14 High flow nasal canula (HFNC) 4, nasal Continuos Positive Airway Pressure (nCPAP) 4, and Invasive ventilation (IV),2. Mean duration of hospital stay was 3 days. All neonates survived. Conclusion: A series of 27 term neonates with community acquired pneumonias during an RSV outbreak is reported in the aftermath of lifting of COVID restrictions. Many of these pneumonias were severe enough to require significant respiratory support. The outcome was good in all babies.