Persistent SARS-CoV-2 Positive Tests in Neonates: Clinical Outcomes, Transmission Pathways, and Immune Vulnerability-Case Series.

Background: In 2020, the World Health Organization declared a Public Health Emergency of International Concern due to the global outbreak of SARS-CoV-2. Recognized as a severe and highly contagious disease, it affected both the adult and pediatric population. However, due to the early timing of the pandemic, limited research was conducted in the perinatal field, leaving many questions regarding the true impact of maternal transmission to fetuses and its consequences during the neonatal period. Methods: In this case series, we reviewed data from ten newborns delivered in the Instituto Nacional de Perinatología (INPer) in Mexico City (tertiary referral institute), all from high-risk pregnancies, between November 2020 and January 2021, all of whom tested positive for SARS-CoV-2 at various points during their hospital stay. Results: Despite showing correct extrauterine adaptation after birth, several of them developed complications such as sepsis, superinfections, inadequate weight gain, and, in some cases, death. Conclusions: These results highlight the urgent need for targeted neonatal care protocols and further research to better understand the impact of persistent viral positivity and immune vulnerability in this population.