Abstract
Background: The coronavirus disease (COVID-19) has spread worldwide with an increasing number of patients, including pregnant women and neonates. This study aims to evaluate morbidity and mortality in the COVID-19 era compared to the preceding year in the Neonatal Intensive Care Unit (NICU) at Tamale Teaching Hospital, Ghana.Methods: This is a cross-sectional study carried out on neonates admitted to NICU between March 1st to August 31st, 2019 (pre-COVID-19 era) and March 1st to August 31st, 2020 (COVID-19 era). Multivariate logistic regression was performed to identify predictors of mortality for both periods.Results: From 2,901 neonates, 1,616 (56%) were admitted before, and 1,285 (44%) were admitted during the pandemic. Admissions decreased during the COVID-19 era, reaching their lowest point between June and August 2020. Compared to the previous year, during the COVID-19 era, admissions of patients born at TTH, delivered at home, and with infections decreased from 50 to 39%, 7 to 4%, and 22 to 13%, respectively. Referred status (OR = 3.3) and vaginal delivery (OR = 1.6) were associated with an increased likelihood of mortality. For low- birth weight neonates, admissions of patients born at TTH, with vaginal and home delivery decreased from 62 to 48%, 8 to 2%, and 59 to 52%, respectively. Neonatal infections and congenital anomalies decreased from 8 to 4%, 5 to 3%, respectively. The likelihood of mortality among referred patients increased by 50%.Conclusion: We observed a marked decrease in admissions and change in the diagnosis landscape and related mortality during the pandemic. Underlying challenges, including fear, financing, and health system capacity, might intensify delays and lack of access to newborn care in northern Ghana, leading to higher rates of lifelong disabilities and mortality. Immediate damage control measures, including an improved home-based continuum of care and equipping families to participate in the newborn care with complemented m-health approaches, are needed with urgency.
Highlights
Severe acute respiratory syndrome-related coronavirus 2 (SARSCoV-2) is the strain of the virus with the typical symptoms at the onset of illness, including fever, difficulty in breathing, dry cough, and fatigue [1]
The pre-COVID-19 era was defined as neonatal admissions from March 1st to August 31st, 2019
Immediate damage control measures, including an improved home-based continuum of care and equipping families to participate in the newborn care with complemented m-health approaches are needed to mitigate the impact of the COVID19 pandemic in newborn care in northern Ghana [31]
Summary
Severe acute respiratory syndrome-related coronavirus 2 (SARSCoV-2) is the strain of the virus with the typical symptoms at the onset of illness, including fever, difficulty in breathing, dry cough, and fatigue [1]. The disease caused by this virus was named Coronavirus disease 19 (COVID-19) by the WHO on February 11th, 2020 [2]. Transmission of the disease is through human-to-human respiratory droplets from a cough or sneeze and fomites [5]. COVID-19 has and is still spreading rapidly across the globe with an increasing number of patients, including pregnant women and neonates [7]. The coronavirus disease (COVID-19) has spread worldwide with an increasing number of patients, including pregnant women and neonates. This study aims to evaluate morbidity and mortality in the COVID-19 era compared to the preceding year in the Neonatal Intensive Care Unit (NICU) at Tamale Teaching Hospital, Ghana
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