Background: The hyperinflammatory state of multisystem inflammatory syndrome in children (MIS-C) predisposes to thromboembolic complications. We report a neonate with multiple cavitary lesions in lung, which we suspect could be a manifestation of multisystem inflammatory syndrome in neonate (MIS-N) following maternal COVID-19 infection during pregnancy.Case Report: Eight-day-old neonate was referred with fever and fast breathing.Mother was positive for COVID-19 in 29th week. COVID-19 reverse-transcription polymerase chain reaction was negative, however, antibodies were positive. He had increased leucocyte count, and elevated levels of C-reactive protein (CRP), procalcitonin, ferritin, lactate dehydrogenase, and D-dimer along with bilateral reticulonodular opacities on chest radiograph and multiple nodules with evidence of cavitation in both lungs on chest tomography. All cultures were negative. A possible diagnosis of MIS was made. Infant was treated with intravenous immunoglobulin (IVIG) which he responded to with resolution of symptoms. Conclusion:Neonates exposed to COVID-19 should be evaluated for thromboembolic complications and IVIG can be one of the treatment modalities.

Vertical transmission of the COVID-19 virus from mother to fetus seems to be uncommon, but, the immunological response of the neonates exposed to maternal infection in-utero, needs further research. The hyperinflammatory state of Multisystem inflammatory syndrome in children (MIS-C) predisposes to thromboembolic complications, including pulmonary thromboembolism (PTE). We report a neonate who had multiple cavitary lesions in lung, which we suspect could be a manifestation of MIS-N following maternal COVID-19 infection during pregnancy.

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