Previously healthy baby, less than two months old, dies of COVID-19 in Montreal hospital

A Montreal infant who had no pre-existing health concerns has died of COVID-19 at one of the city's children's hospitals this week, the hospital said Friday.

The baby was less than two months old on Thursday when he or she died, Sainte-Justine Hospital said in a news release.

"The University Hospital regrets to announce the death within its walls of a baby under two months of age from COVID-19," a hospital spokesperson wrote.

"The child, healthy at birth, was recently hospitalized in intensive care due to COVID and died on December 16."

The hospital is providing no other details about the case and won't grant any interviews because of the need for confidentiality, it said.

But it "wishes to offer its sincere condolences to the parents and the family of the infant," it said.

It also wanted to remind the public "that infants are at greater risk of complications linked to COVID-19" and that it's necessary to take precautions to reduce transmission around them.

That includes reducing contacts, wearing masks, handwashing, social distancing of two metres, and "the vaccination of relatives."

Deaths of young children in Canada from COVID-19 have been extremely rare.

Chief Public Health Officer of Canada Theresa Tam said in late November that over the course of the pandemic there have been fewer than 20 fatalities among those under 19.

In Quebec, two teenagers have died of the virus, including a 16-year-old girl, the province's youngest victim until now.

Around the world, deaths of babies and children have also been rare. The United Kingdom, with a population nearly twice the size of Canada's, has seen only 25 deaths of people under 18.

The United States, with its much bigger population and much lower vaccination rate, has marked 771 deaths of children under 18, according to data from the Centers for Disease Control. An outsized proportion of those deaths, nearly 44 per cent, were among children four and younger.

BABIES' SMALL AIRWAYS MAKE THEM VULNERABLE

What makes COVID-19 especially dangerous to small babies is that it attacks the airways, which in infants are tiny and easily blocked.

This risk is well known among pediatricians when it comes to many viruses, said Dr. Jesse Papenburg, a Montreal pediatric epidemiologist.

"Newborns’ and very young babies’ smaller airways are more easily blocked by mucus and secretions if a virus goes down into the lungs," he said, making it more likely they'll need "oxygen or other forms of respiratory support."

The virus that causes the common cold in adults often turns far more serious for infants -- a full two per cent of all infants in North America are hospitalized for this virus, called RSV, before they turn one.

"Generally speaking, respiratory virus infections tend to be more severe in children under three months of age," Papenburg said,  which "is also likely the case for COVID-19."

Data from the Public Health Agency of Canada have led doctors to the same conclusion, suggesting that infants under a year old have a higher risk of being hospitalized with COVID-19 than older children do, Papenburg said.

Like Ste-Justine, he said that it's necessary to take extra precautions in a baby's first weeks of life, including washing hands frequently and limiting the number of people the baby is in contact with, especially avoiding sick people.

"COVID-19 vaccination of family members can also help to protect those too young to be immunized," he said.

Experts also stressed the importance of expectant mothers getting vaccinated, since this is the only way babies can have antibodies against COVID-19 in their earliest months.

"Vaccination of pregnant women is especially important to prevent severe COVID-19 during pregnancy, but also likely protects babies during early life by transfer of mom’s antibodies during the third trimester and during breastfeeding," said Papenburg.

"Babies... are born with an immature immune system, which prevents them from being able to fight off infections properly," said another Montreal infectious diseases specialist, Dr. Donald Vinh.

The antibodies that the mom produces act as “major barriers” against infection, after they "get passed on to the fetus, providing the baby protection for the first six to nine months of life," he said, while the baby's own immune system is maturing to the point that it can provide its own defences.

"For this reason, it has long been recognized that women who are planning to become pregnant, or who are pregnant, should be up to date with their vaccinations," said Vinh.

This is partly why Quebec and other jurisdictions have been changing immunization schedules to give pregnant women priority, he said -- to help them get up to date in time to pass on these antibodies to their babies.

As for the safety of COVID-19 vaccines, Vinh said data over the last year have consistently shown they “are safe to give to pregnant women, with no increases in complications, such as miscarriages or stillbirths, and no deformities or harms to the fetuses.”