NICU ward management during the SARS-CoV-2 outbreak

Abstract

Little evidence is available that positively suggests the vertical transmission of severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2）, which became a pandemic beginning the end of 2019, from mothers to neonates. However, a neonate is considered to be possibly infected with coronavirus disease 2019 （COVID-19） when a mother is suspected to be infected with or is undergoing a test for SARS-CoV-2 polymerase chain reaction （PCR） at delivery, necessitating infection measures immediately upon his/her birth to prevent nosocomial infection. This study aims to clarify the current situation and changes made in the management of neonatal intensive care unit （NICU） wards during the spread of infection to utilize this information for future infection measures. This study retrospectively investigated the changes made in NICU ward management and the inpatient breakdown over a 1 month （approximate） from the introduction of PCR testing for all patients until the declaration of the state of emergency was lifted. Consequently, seven neonates were admitted to the negative-pressure private room during the investigation period. Neonatal resuscitation, with personal protective equipment attached, was performed with an open incubator at least 2m away from the mother to prevent nosocomial infections. After resuscitation, the neonate was immediately placed in a waiting incubator and transferred to the NICU. The nurse who worked in a negative-pressure private room was exclusively assigned. Moreover, the number of beds in the negative-pressure private room was reduced from two to one due to the change in staffing. Moreover, the visit of the parents was forced to change to a shift system and time limit. Infection measures were implemented at the NICU ward during the spread of COVID-19. The changes in the management of the NICU ward that was experienced during this time should be clarified so that the information can be utilized for future infection measures with the assumption of measures that are in place during normal situations.