J Pediatr Genet
DOI: 10.1055/s-0040-1718874
Case Report

Acute COVID-19 Infection in a Pediatric Patient with ROHHAD

1   Department of Emergency Medicine, Loma Linda University Medical Center, Loma Linda, California, United States
,
Merrick Lopez
2   Division of Pediatric Critical Care, Department of Pediatrics, Loma Linda University Children’s Hospital, Loma Linda, California, United States
,
Michael Avesar
2   Division of Pediatric Critical Care, Department of Pediatrics, Loma Linda University Children’s Hospital, Loma Linda, California, United States
,
Sonea Qureshi
2   Division of Pediatric Critical Care, Department of Pediatrics, Loma Linda University Children’s Hospital, Loma Linda, California, United States
,
Anthony Moretti
2   Division of Pediatric Critical Care, Department of Pediatrics, Loma Linda University Children’s Hospital, Loma Linda, California, United States
,
Shamel A. Abd-Allah
2   Division of Pediatric Critical Care, Department of Pediatrics, Loma Linda University Children’s Hospital, Loma Linda, California, United States
,
Harsha K. Chandnani
2   Division of Pediatric Critical Care, Department of Pediatrics, Loma Linda University Children’s Hospital, Loma Linda, California, United States
› Author Affiliations
Funding None.

Abstract

The novel coronavirus (severe acute respiratory syndrome coronavirus-2) has led to a global pandemic. In the adult population, coronavirus disease 2019 (COVID-19) has been found to cause multiorgan system damage with predicted long-term sequelae. We present a case of a 10-year-old boy with a history of ROHHAD (rapid-onset obesity with hypothalamic dysregulation, hypoventilation, and autonomic dysregulation) who presented with hypoxia, emesis, and abdominal pain. Imaging found bilateral ground glass opacities in the lungs and a pericardial effusion. Laboratory evaluation was concerning for elevated inflammatory markers. Remdesivir, hydroxychloroquine, and anticoagulation (heparin and enoxaparin) were utilized. The patient's severe respiratory failure was managed with conventional mechanical ventilation, inhaled nitric oxide, and airway pressure release ventilation. We hope that this report provides insight into the course and management of the severe acute pediatric COVID-19 patient, specifically with underlying comorbidities such as ROHHAD. Clinical trial registration is none.

Authors' Contributions

D.S.U. and H.K.C. conceptualized the report, drafted the initial manuscript, and assisted in revisions. M.L., M.A., S.Q., A.M., and S.A.A.-A. extracted and assembled the relevant data from the patient's hospital course, critically reviewed the manuscript for important intellectual content, and revised the manuscript. All authors contributed directly in the patient's care for an extended period of time. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.




Publication History

Received: 17 July 2020

Accepted: 14 September 2020

Article published online:
26 October 2020

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