During this covid-19 pandemic, a few cases of vertical transmission of severe acute respiratory syndrome coronavirus-2 from mothers to the fetus have been documented. Anti-SARS CoV-2 antibodies mediated multisystem inflammatory response syndrome (MIS-C) is known phenomenon in children. With this case report, we aim to demonstrate the evidence of fetal inflammatory response syndrome (FIRS) associated with anti-SARS CoV-2 antibodies in a premature neonate presenting with respiratory distress, seizures and shock in initial hours of life. The infant was RTPCR negative for covid-19, but positive for anti-SARS CoV-2 antibodies with raised inflammatory markers, suggestive of systemic inflammatory response syndrome. A comprehensive workup for other infectious pathogens also came up negative. Baby received IvIg and steroids and recovered completely. We believe that this systemic inflammation occurred due to antenatal exposure to the covid-19 virus and that more such instances will emerge in future.Baby's perfusion improved gradually over 48 hours
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