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J Pediatr Infect Dis 2022; 17(04): 216-220
DOI: 10.1055/s-0042-1750313
Case Report

COVID-19 Lung Damage in a Preterm Newborn

Amal Khalouaoui
1   Department of Neonatology, North Hospital, Assistance Publique des Hôpitaux de Marseille University Hospital, Chemin des Bourrely, Marseille, France
,
Paul Habert
2   Department of Radiology, La Timone Hospital, Assistance Publique des Hôpitaux de Marseille, Marseille, France
,
Marion Dequin
1   Department of Neonatology, North Hospital, Assistance Publique des Hôpitaux de Marseille University Hospital, Chemin des Bourrely, Marseille, France
,
Catherine Gire
1   Department of Neonatology, North Hospital, Assistance Publique des Hôpitaux de Marseille University Hospital, Chemin des Bourrely, Marseille, France
,
Barthélémy Tosello 
1   Department of Neonatology, North Hospital, Assistance Publique des Hôpitaux de Marseille University Hospital, Chemin des Bourrely, Marseille, France
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Abstract

The new coronavirus disease 2019 (COVID-19) was declared responsible for a global pandemic by the World Health Organization (WHO) on March 11, 2020. It created, since its emergence, a special concern in neonates given their immature immune system and their frequent contact with caregivers.

Monochorionic very preterm female neonate (315/7 weeks of gestation) with growth retardation had at 3 weeks of age severe lung damage following an acute respiratory failure caused by horizontally transmitted severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. Before this acute episode, she was without respiratory support apart from 7 days of positive airway pressure following a respiratory distress syndrome. Both of her parents, her twin sister, and her referent nurse tested positive for SARS-CoV-2. Chest radiographs showed bilateral alveolar infiltration. Chest computed tomography (CT) scan detected multiple ground-glass opacifications in both lungs along with ventilation disorders and bronchial wall thickening. Neonate paraclinical tests showed a negative C-reactive protein and hypogammaglobulinemia. Mechanical ventilation was needed for 1 week along with sedation, pharmaceutically induced paralysis, and inhaled nitric oxide. Severe bronchopulmonary dysplasia revealed by oxygen dependency at 36 weeks of gestation was treated with steroids and noninvasive respiratory support. The neonate was discharged with free oxygen at home.

Her twin sister, also SARS-CoV-2–positive, only needed noninvasive ventilation for 19 days.

Severe forms of COVID-19 in premature neonates, with long-term respiratory sequelae, are possible. Considering the lack of data in this age group, more studies are needed to investigate the risk factors associated with severe symptoms, the effects of specific treatments, and the long-term prognosis of the disease.

Keywords

coronavirus disease 2019 - respiratory distress syndrome - preterm infant


Publication History

Received: 10 February 2022

Accepted: 05 May 2022

Article published online:
11 July 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Dhir SK, Kumar J, Meena J, Kumar P. Clinical features and outcome of SARS-CoV-2 infection in neonates: a systematic review. J Trop Pediatr 2021; 67 (03) 59
    PubMedGoogle Scholar
  • 2 Ng KF, Bandi S, Bird PW, Wei-Tze Tang J. COVID-19 in neonates and infants: progression and recovery. Pediatr Infect Dis J 2020; 39 (07) e140-e142
    CrossrefPubMedGoogle Scholar
  • 3 Centers for Disease Control and Prevention. Interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19) [Internet]. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html?fbclid=IwAR1F0VaNyTWmdmN5eD_vnvAfsEZpd4×6aR-91wbIEL-nVKSAa9kr5LAX-6c
    PubMedGoogle Scholar
  • 4 Gale C, Quigley MA, Placzek A. et al. Characteristics and outcomes of neonatal SARS-CoV-2 infection in the UK: a prospective national cohort study using active surveillance. Lancet Child Adolesc Health 2021; 5 (02) 113-121
    CrossrefPubMedGoogle Scholar
  • 5 Sun Z, Zhang N, Li Y, Xu X. A systematic review of chest imaging findings in COVID-19. Quant Imaging Med Surg 2020; 10 (05) 1058-1079
    CrossrefPubMedGoogle Scholar
  • 6 Farmer ML. A neonate with vertical transmission of COVID-19 and acute respiratory failure: a case report. Adv Neonatal Care 2021; 21 (06) 482-492
    CrossrefPubMedGoogle Scholar
  • 7 Cakir U, Demirel MA, Yuksek SK, Tugcu AU, Tufan N, Tayman C. Case report of severe COVID-19 pneumonia in a term newborn. J Trop Pediatr 2021; 67 (04) 23
    CrossrefPubMedGoogle Scholar
  • 8 Kumar VHS, Prasath A, Blanco C. et al. Respiratory failure in an extremely premature neonate with COVID-19. Children (Basel) 2021; 8 (06) 477
    PubMedGoogle Scholar
  • 9 Morales HSG, Cortés DV, Hernández HS. et al. Vertical transmission: evidence of COVID-19 in a twin pregnancy. JBRA Assist Reprod 2022; 26 (01) 153-157
    PubMedGoogle Scholar
  • 10 Piersigilli F, Carkeek K, Hocq C. et al. COVID-19 in a 26-week preterm neonate. Lancet Child Adolesc Health 2020; 4 (06) 476-478
    CrossrefPubMedGoogle Scholar
  • 11 Nyholm S, Edner A, Myrelid Å, Janols H, Dörenberg R, Diderholm B. Invasive mechanical ventilation in a former preterm infant with COVID-19. Acta Paediatr 2020; 109 (10) 2141-2143
    CrossrefPubMedGoogle Scholar
  • 12 Meyts I, Bucciol G, Quinti I. et al; IUIS Committee of Inborn Errors of Immunity. Coronavirus disease 2019 in patients with inborn errors of immunity: an international study. J Allergy Clin Immunol 2021; 147 (02) 520-531
    CrossrefPubMedGoogle Scholar