Prevalence of certain bacterial coinfections low for young COVID-19-positive febrile infants

Febrile infants aged 8 to 60 days old who test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have a low prevalence of urinary tract infection (UTI), bacteremia, and bacterial meningitis, according to a study published online May 12 in JAMA Network Open.

Paul L. Aronson, M.D., from the Yale School of Medicine in New Haven, Connecticut, and colleagues describe the prevalence of UTI, bacteremia, and bacterial meningitis among febrile infants aged 8 to 60 days with versus without SARS-CoV-2 in a multicenter cross-sectional study conducted at 106 hospitals in the United States and Canada. Data were included for 14,402 febrile infants, aged 8 to 60 days, with SARS-CoV-2 testing (26.1 percent tested positive).

The researchers found that a lower proportion of infants who tested positive for SARS-CoV-2 compared with those who tested negative had UTI (0.8 versus 7.6 percent), bacteremia without meningitis (0.2 versus 2.1 percent), and bacterial meningitis (<0.1 versus 0.5 percent). Among infants aged 29 to 60 days who tested positive for SARS-CoV-2, 0.4, <0.1, and <0.1 percent had UTI, bacteremia, and meningitis, respectively. Among SARS-CoV-2-positive infants, the proportion with bacteremia and/or bacterial meningitis was lower for those with normal versus abnormal inflammatory markers (<0.1 versus 1.8 percent).

"Infants with SARS-CoV-2 positivity had very low prevalence of UTI, bacteremia, and bacterial meningitis," the authors write. "Given these findings, the integration of SARS-CoV-2 testing results into the risk stratification of febrile infants merits future study."

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