Compared with feverish infants who tested negative for COVID-19, a lower proportion of babies aged 8 to 60 days who tested positive had co-occurring urinary tract infections (UTIs), bacteremia without meningitis, and bacterial meningitis, according to a study published late last week in JAMA Network Open.
Bacteremia is the presence of bacteria in the bloodstream, and meningitis is inflammation of the membranes that protect the brain and spinal cord.
Led by a Yale School of Medicine researcher, the study was part of a quality-improvement project at 106 US and Canadian hospitals from November 1, 2020, to October 31, 2022. Participants were full-term and feverish but otherwise healthy infants without bronchiolitis (lung infection in infants and young children) who were tested for COVID-19.
Among 14,402 infants, 58.4% were 29 to 60 days old, 56.5% were boys, 26.1% tested positive for COVID-19, 39.8% were White, 25.0% were Hispanic, 13.3% were of another race, 12.5% were of unknown race, and 9.4% were Black.
Bacterial infections varied by age, inflammatory markers
Compared with infants who tested negative, a lower proportion of those who tested COVID-positive had UTI (0.8% vs 7.6%), bacteremia without meningitis (0.2% vs 2.1%), or bacterial meningitis (<0.1% vs 0.5%).
Among infants 29 to 60 days old diagnosed as having COVID-19, 0.4% had UTI, and less than 0.1% each had bacteremia or meningitis. Of SARS-CoV-2–positive infants, a lower proportion of those with normal levels of inflammatory markers (IMs) had bacteremia and/or bacterial meningitis than those with abnormal IMs (<0.1% vs 1.8%).
It is important to note that the prevalence of concomitant bacterial infection varied by age group.
"Although the prevalence of UTI and IBI [invasive bacterial infection] may be low enough for some clinicians to consider deferring further testing for bacterial infection in SARS-CoV-2–positive infants, depending on their risk tolerance and practice setting, it is important to note that the prevalence of concomitant bacterial infection varied by age group and whether IMs were normal or abnormal," the study authors wrote.