Coronavirus disease 2019 (COVID-19) is a viral respiratory infection caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). While SARS-CoV-2 is a leading cause of morbidity and mortality in older adults, COVID-19 also affects newborn infants in nurseries and the Neonatal Intensive Care Units (NICUs). The majority of infected neonates are believed to acquire SARS-CoV-2 by horizontal transmission, and most of them have asymptomatic or mild symptomatic infections. In rare cases, infants with COVID-19 may have severe complications resulting in death. We report a case of COVID-19 in a premature neonate born at 34 weeks gestational age who presented with hypothermia and respiratory distress and subsequently developed clinical and radiological signs of necrotizing enterocolitis (NEC). The neonate received medical management, including antibiotics, suspension of gastric feeds, and intensive NICU support. The neonate’s clinical condition improved without surgical intervention, and after 10 days of antibiotics and gradual reestablishment of gastric feeds, patient health condition returned to normal, and weeks later, he was discharged home. COVID-19 in infants is frequently asymptomatic or associated with mild disease, and in rare cases, it may be associated with severe gastrointestinal complications including NEC.

INTRODUCTION: To determine the outcomes including complications that occur when an emergency code, “Condition Pink” is used on labor and delivery for either maternal or fetal reasons. METHODS: Retrospective chart review was conducted on all patients who delivered at New York University – Lutheran Medical Center between January 2014 and December 2015. Fifty – eight patients had a “Condition Pink” called. Mode of delivery, neonatal Apgar scores and maternal complications such as infection, hemorrhage, and bladder injury were reported. Also reviewed were readmissions to the hospital. Because majority of these women had cesarean deliveries, they were compared to women who underwent cesarean deliveries during that same time period. Statistical significance was assessed using the chi-squared test. RESULTS: All 56 emergent cesarean deliveries and a random sample of 96 non-emergent cesarean deliveries were selected. Patients requiring an emergent cesarean delivery were found to have a 16% (9/56) chance of overall maternal complications while non-emergent cesarean deliveries had only a 5% (5/96) chance (P=0.039). Risk of individual maternal complications, including postpartum hemorrhage, bowel or bladder injury, and postoperative infection were also evaluated, but these individual outcomes were relatively rare and differences between groups were not statistically significant. CONCLUSION: Emergent Cesarean sections (where a maternal or fetal emergency warrants immediate delivery of the fetus) carry an increased risk of overall maternal complications.