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A Term Infant Presenting with COVID-19 Disease at Birth and a Croup-Like Cough

Michelle Arnold1,2,3, Christine Wade3,4, Becky Micetic3,4

  • 1College of Medicine, University of Arizona College of Medicine, Phoenix, Arizona.

American Journal of Perinatology
|June 17, 2022
PubMed

Insights

A newborn infant contracted COVID-19 at birth and developed a persistent, croup-like cough. Standard respiratory treatments were ineffective, necessitating prolonged hospitalization and intensive care. This case highlights unique COVID-19 presentations in neonates.

Area of Science:

  • Neonatology
  • Pediatric Infectious Diseases
  • Virology

Background:

  • The novel coronavirus disease 2019 (COVID-19) has been associated with various symptoms in children, including croup-like coughs.
  • Information regarding COVID-19 in newborn infants, particularly concerning vertical transmission, remains limited, with vertical transmission considered rare.
  • This case report focuses on a term newborn diagnosed with COVID-19 at birth.

Observation:

  • A term infant diagnosed with COVID-19 at birth experienced respiratory distress, requiring transfer to the neonatal intensive care unit.
  • The infant necessitated endotracheal intubation on day of life 7 due to escalating respiratory support needs.
  • Following extubation on day of life 21, the infant developed a persistent croup-like cough.

Findings:

  • Despite comprehensive respiratory treatments including albuterol, budesonide, racemic epinephrine, lidocaine, dornase alfa, and a 10-day course of dexamethasone, the croup-like cough did not resolve.
  • The infant required an extended hospitalization period, ultimately being discharged on day of life 95 with supplemental oxygen support.
  • This case underscores a complicated clinical course for a neonate with congenital COVID-19 infection.

Implications:

  • The evolving nature of the COVID-19 virus can lead to diverse clinical presentations in both pediatric and adult populations.
  • Increased provider vigilance and rapid dissemination of new findings are crucial for effectively managing infants diagnosed with COVID-19.
  • This case highlights the potential for severe respiratory complications, including croup-like symptoms, in neonates with COVID-19, emphasizing the need for tailored treatment strategies.
Abstract

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