Critical care among newborns with and without a COVID-19 diagnosis, May 2020–February 2022

Objective To assess COVID-19 association with newborn critical care outcomes, including nursery level of care and ventilation, during three time periods: Pre-delta (May 2020–June 2021), Delta (July–November 2021), and Omicron (December 2021–February 2022). Study design In a retrospective cohort of newborns born May 2020–February 2022 using the Premier Healthcare Database, we classified COVID-19 status and critical care using International Classification of Diseases 10th Revision and Current Procedural Terminology codes, laboratory data, and billing records and assessed for variation during three time periods. Results Of 1,388,712 newborns, 0.06% had COVID-19 during the birth hospitalization (Pre-delta period: 0.03%; Delta: 0.07%; Omicron: 0.21%). Among newborns with COVID-19, the risks for admission to a higher-level nursery and for invasive or non-invasive ventilation were lower in the Omicron period compared to Pre-delta and Delta periods. Conclusion From May 2020–February 2022, COVID-19 in newborns was rare and cases were less severe during the period of Omicron predominance.