COVID-19 in a Three-Year-Old Girl With Total Anomalous Pulmonary Venous Return: A Case Report

Total anomalous pulmonary venous return (TAPVR) is a rare congenital heart disease (CHD) with an incidence of less than 1%. It is known that coronavirus disease 2019 (COVID-19) has a worse prognosis in those with underlying disorders. Children with congenital heart defects can contract COVID-19 irrespective of their surgical correction status. We report a case of a three-year-old girl with unoperated TAPVR, who presented with respiratory distress, lethargy, and reduced feeding. Reverse transcription polymerase chain reaction (RT-PCR) of nasopharyngeal aspirate came back positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There was no growth of any other viral or bacterial pathogens. Throughout her admission, she had an overall mild course of the disease and did not need mechanical ventilation. Oxygen was given via nasal cannula to maintain SpO₂ in the target range. Chest X-ray (CXR) showed bilateral patchy consolidation while a chest CT with contrast showed significant venous congestion. Her length of hospital stay was 25 days. Infection with SARS-CoV-2 did not cause a critical disease and was not different clinically to any other bacterial or viral infection. The potential risk of further cardiac deterioration in COVID-19 in any CHD should be handled with caution as these children can decompensate rapidly.