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COVID-19-related ARDS in a young infant with uncontrolled HIV after delay in EID

Farah A Falix1, Sylke J Nikkels2, Ginette M Ecury-Goossen3

  • 1Department of pediatrics Curacao Medical Center, Willemstad, Curacao, Curaçao. farah.falix@cmc.cw.

AIDS Research and Therapy
|October 15, 2025
PubMed

Insights

Infants with HIV, especially those with delayed diagnosis, face severe COVID-19 risks. This case highlights the critical need for uninterrupted HIV prevention services during pandemics.

Area of Science:

  • Pediatric Infectious Diseases
  • Immunology
  • Public Health

Background:

  • COVID-19 typically causes mild illness in children.
  • Pediatric patients with primary immunodeficiency are at higher risk for severe COVID-19.
  • Severe COVID-19 can be fatal in immunocompromised children.

Purpose of the Study:

  • To report a case of severe COVID-19 in an infant with undiagnosed vertical HIV transmission.
  • To emphasize the potential for delayed HIV diagnosis during the COVID-19 pandemic.
  • To highlight the impact of pandemic-related barriers on HIV prevention services.

Main Methods:

  • Case report of a 3.5-month-old infant with COVID-19-related acute respiratory failure.
  • Infant diagnosed with vertical HIV transmission.
  • Mother received antiretroviral therapy; infant received neonatal prophylaxis.
  • Initial HIV screenings were negative; follow-up screening was planned.

Main Results:

  • The infant presented with severe COVID-19 and acute respiratory failure.
  • This is the first pediatric case of severe COVID-19 morbidity in an HIV-immunocompromised infant.
  • Delayed diagnosis of vertical HIV transmission occurred despite antiretroviral exposure.

Conclusions:

  • Awareness of delayed vertical HIV transmission diagnosis is crucial, even with prior antiretroviral exposure.
  • COVID-19 pandemic barriers delayed HIV prevention, stressing the need for service continuity.
  • This case underscores the severe risks of COVID-19 in immunocompromised infants with HIV.
Abstract

Keywords:
ARDSCOVID-19Early-infant-diagnosisHIVImmunocompromiseVertical transmission

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