Acute mesenteric ischemia in a newborn with COVID-19: A case report

We aimed to report a case of acute mesenteric ischemia in a newborn with COVID-19.

A 1-day-old male baby, with a birth weight of 2050 g, delivered by spontaneous vaginal delivery at 34 weeks of gestation from a 32-year-old COVID-19 infected mother in her third pregnancy, was taken to the newborn intensive care unit. On physical examination, the patient was alive and active. The abdomen was soft. Laboratory values of the patient were within the normal range. Echocardiography and abdominal ultrasonography were normal. COVID-19 PCR test drawn at 48 h of age was positive. On the postnatal 4th day, the patient suddenly had tachycardia and abdominal tension. Free air in the abdomen was detected on direct abdominal X-ray. The patient was taken to surgery urgently. On laparotomy, brownish ascites and necrotic small bowel and colon starting from 20 cm of ligamentum of Treitz to the middle part of the transverse colon were seen. Jejunostomy was constructed at area that 50 cm distal to Treitz with a relatively better appearance (with circulatory disorder but not full-thickness necrosis) and transverse colon mucous fistula without primary anastomosis. The patient died one day after surgery due to cardiorespiratory arrest and multiorgan failure.

Although most of the reported symptoms of the COVID-19 are related to the respiratory system, there is concern that the occurrence of serious and life-threatening manifestations such as mesenteric ischemia in the gastrointestinal tract may be overlooked in also neonatal period.