we reported a case of late congenital cystic malformation (CCAM) diagnosis with problematic COVID-19 infected condition during delivery and dilemmatic neonatal management. A 24-year-old pregnant woman, second pregnancy, came very late in pregnancy (38 weeks gestational age), misdiagnosed with congenital diaphragmatic hernia. Our ultrasound examination revealed congenital cystic malformation type-1 in the right lung, with some of the normal lung lobes. The Left side lung was normal. CCAM volume ratio (CVR) 2,79 cm. Due to COVID-19 infection, our multidisciplinary team decided to perform quick chest tube insertion during the ex-utero intrapartum therapy (EXIT) procedure to avoid pneumothorax complications continued with intubation for the newborn. Neonatal middle right lung lobectomy was done after optimal condition at 20 days old with pathology anatomic result of CCAM type 1. The diagnosis, type, and prognosis of CCAM should be established earlier to make enough time for the better-prepared multidisciplinary management of the newborn.

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Background Healthcare workers are still the front liners in health care services, and have major roles during the COVID-19 pandemic. In a resource-limited country like Indonesia, it is necessary to provide safe screening and management both for patients and healthcare workers to minimize the transmission. We report our experience in the cardiac surgery department on how to provide safe management during the COVID-19 pandemic. Methods A retrospective observational study was performed in a single-tertiary-center cardiac surgery department in Surabaya and included all patients who underwent cardiac surgery during the first year of the COVID-19 pandemic. We also collected the patients from a 1-year period before the pandemic as the comparison data. Analysis of the patient characteristics, operative data, and postoperative outcome, was performed. This study also provides our experience in changes of admission in the cardiac surgery preoperative system that can be utilized for others. Results A total of 179 patients were admitted to and had cardiac surgery. Of these, 3.80% ( n = 7) were COVID-19 confirmed by a real-time polymerase chain reaction. Five patients were delayed to have cardiac surgery with no mortality or morbidity reported in these patients. During the period after changes of admission procedural in cardiac surgery patients, there were no healthcare workers infected by COVID-19 by patient transmission in our center (0%). Conclusion Our study reported a systematic screening and that possible delay in cardiac surgery appears to be feasible and safe, both for patients and for healthcare workers during the COVID-19 pandemic.