Background: Significant improvement in neonatal care has enabled increasing survival of preterm infants. Metabolic bone disease of prematurity is often overlooked due to other comorbidities of preterm birth. The best approach is screening and prevention of the disease in high-risk infants such as preterm infants. Aim: We followed up the clinical, radiological, and serum biochemical markers of metabolic bone disease in extremely preterm infants (<28 weeks of gestation). The clinical applicability and validation of C-terminal telopeptide of type I collagen (CTX-I) as a novel bone turnover marker were assessed. Standard and novel biochemical bone turnover markers and quantitative ultrasound were compared. Method: Patients’ data were collected from medical records. Assessments of calcium, phosphate, alkaline phosphatase, bone-alkaline phosphatase, CTX-I, and quantitative ultrasound were prospectively performed twice in 42 extremely preterm infants at postmenstrual ages of 30–32 weeks and 36–40 weeks. Bone mineral density was measured by quantitative ultrasound. Conclusion: Phosphate, alkaline phosphatase, bone alkaline phosphatase, calcium, or ionized calcium are not related to gestational age, but bone mineral density, measured by quantitative ultrasound, is related. There is no correlation between standard and novel biochemical markers and quantitative ultrasound for the identification of metabolic bone disease.

Objective − In this study we aimed to compare the occurrence of lower respiratory tract infections caused by respiratory syncytial virus in the neonatal population in the years before and during the COVID-19 pandemic. Methods − Cases of newborns, hospitalized due to viral lower respiratory tract infection from 2015 to 2020, were analyzed retrospectively, and compared according to cause (respiratory syncytial virus, non-respiratory syncytial virus) and treatment requirements before (2015−2019) and after (2020) the outbreak of the COVID-19 pandemic. Results − The number of newborns with lower respiratory tract infections and newborns contracting respiratory syncytial virus declined significantly during the COVID-19 pandemic. Respiratory syncytial virus was the major causative agent before the pandemic, while after the lockdown no more cases were reported. There were no significant differences between the two periods regarding the number of patients requiring treatment with oxygen (P=0.705), non-invasive (P=0.842) and invasive ventilation (P=0.574), or in terms of median hospital stay (P=0.670) and the duration of non-invasive (P=0.350) and invasive ventilation (P=0.556), while the difference in the duration of treatment with oxygen was statistically significant (P=0.048). Conclusions − A decline was found in the number of newborns hospitalized due to respiratory syncytial virus and non-respiratory syncytial virus lower respiratory tract infections during the COVID-19. Our results strongly suggest that social distancing and other lockdown strategies were effective in slowing down the spread of respiratory syncytial virus and decreasing the need for hospitalization among newborns, but may be not equally effective for all agents causing lower respiratory tract infections.