COVID-19-Related Potential Multisystem Inflammatory Syndrome in Childhood in a Neonate Presenting as Persistent Pulmonary Hypertension of the Newborn

Borkotoky, Rekha Khaund; Barua, Puja Banerjee; Paul, Siba Prosad; Heaton, Paul Anthony

doi:10.1097/inf.0000000000003054

Cited by 50 publications

(60 citation statements)

References 8 publications

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“…Unlike MIS-C, where SARS-CoV-2 infection and multisystem inflammation occur in the same subject, a few case reports suggest neonatal multisystem inflammation [ 13 ] occurs secondary to maternal SARS-CoV-2 infection [ 14 , 15 , 16 , 17 ]. A few weeks after the first wave of COVID-19 in Kolhapur, India, we found an increase in the number of neonates with structurally normal hearts who presented with conduction abnormalities and were born to mothers with a past history of COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series

Gavade²,

et al. 2021

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Multisystem inflammatory syndrome in children (MIS-C) is a post-infectious immune-mediated condition, seen 3–5 weeks after COVID-19. Maternal SARS-CoV-2 may potentially cause a similar hyperinflammatory syndrome in neonates due to transplacental transfer of antibodies. We reviewed the perinatal history, clinical features, and outcomes of 20 neonates with features consistent with MIS-C related to maternal SARS-CoV-2 in Kolhapur, India, from 1 September 2020 to 30 April 2021. Anti-SARS-CoV-2 IgG and IgM antibodies were tested in all neonates. Fifteen singletons and five twins born to eighteen mothers with a history of COVID-19 disease or exposure during pregnancy presented with features consistent with MIS-C during the first 5 days after birth. Nineteen were positive for anti-SARS-CoV-2 IgG and all were negative for IgM antibodies. All mothers were asymptomatic and therefore not tested by RTPCR-SARS-CoV-2 at delivery. Eighteen neonates (90%) had cardiac involvement with prolonged QTc, 2:1 AV block, cardiogenic shock, or coronary dilatation. Other findings included respiratory failure (40%), fever (10%), feeding intolerance (30%), melena (10%), and renal failure (5%). All infants had elevated inflammatory biomarkers and received steroids and IVIG. Two infants died. We speculate that maternal SARS-CoV-2 and transplacental antibodies cause multisystem inflammatory syndrome in neonates (MIS-N). Immunomodulation may be beneficial in some cases, but further studies are needed.

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Section: Introductionmentioning

confidence: 99%

Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series

Gavade²,

et al. 2021

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“…Хайтович М.В., 2 Воронюк Л.М., 2 Борисова Г.Ю., 2 Дюденко Н.В., 2 Мягка Н.М. 1 Національний медичний університет імені О.О.…”

Section: мультисистемний запальний синдром у дітей: маркери діагностики та особливості фармакотерапіїunclassified

“…1 Національний медичний університет імені О.О. Богомольця, Київ, Україна 2 КНП «Київська міська дитяча клінічна лікарня № 2», Київ, Україна nik3061@gmail.com…”

Section: мультисистемний запальний синдром у дітей: маркери діагностики та особливості фармакотерапіїunclassified

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Multisystem Inflammatory Syndrome in Children: Diagnostic Markers and Features of Pharmacotherapy

et al. 2021

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Relevance. In 2020, children were hospitalized with fever and multisystem inflammation throughout the world during the COVID-19 pandemic. In the United States, this condition is called MIS-C (Multisystem Inflammatory Syndrome in Children). This syndrome is thought to be similar to the severe course of COVID-19 in adults (cytokine storm). The objective of the work is to evaluate the features of the course and pharmacotherapy of multisystem inflammatory syndrome in children. Materials and methods. The study included 17 children (10 boys and 7 girls) aged 3-16 years (on average – 9.5±3.4 years). Diagnosis of coronavirus infection was performed by polymerase chain reaction with real-time detection, determined the level of immunoglobulins M and G before coronavirus infection. Results. The duration of fever in patients was 5-21 days (average 8.1±4.0 days), the duration of inpatient treatment – 7-35 days (average 15.7±7.0 days). Blood albumin levels were reduced in 53.8% of children; the level of fibrinogen was increased in 88.2% of children, the level of C-reactive protein, ferritin, and D-dimer – in all patients. 15 (88.2%) children had pathology of the digestive system, 13 (76.5%) – cardiovascular system (7 children were diagnosed with carditis, 2 – dilation of coronary arteries, 7 – cardiac arrhythmia). Acute respiratory distress -syndrome was found in a 13-year-old girl, shock - in an 11-year-old boy, 11 children (64.7%) were diagnosed with the pathology of the respiratory system (pleurisy, pneumonia), skin and mucous membranes, and 4 children (23.5%) there were manifestations of central nervous system disorders (meningism, decreased reflexes, ataxia), in 2 (11.8%) – renal failure. On average, each patient had lesions of 3.9 ±1.2 systems. Conclusions. MIS-C was manifested by prolonged fever, high levels of laboratory markers of inflammation, hypoalbuminemia, hypercoagulation, often – pathological manifestations of the cardiovascular, digestive, respiratory systems, skin, and mucous membranes. The treatment included intravenous immunoglobulin, steroids, anticoagulant, and antibacterial therapy and was effective.

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“…These cases were treated with steroids, which hasten recovery. 9,10 Further study in neonates and infants is needed to elucidate the mode of transmission, risk factors for developing MIS-C and disease severity.…”

Section: Case Reportmentioning

confidence: 99%

Multisystem inflammatory syndrome-neonate: youngest COVID survivor

Singla¹,

Kumar²,

Raavi³

2021

Int J Contemp Pediatr

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The novel corona virus disease (COVID-19) caused by the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is a global public health concern, primarily transmitted through respiratory droplets; though other routes of transmission are documented but not been fully demonstrated. At risk included all age groups, somehow for reasons unknown infants and children appears to be at a lower risk of severe infection, but recently children with hyper inflammatory syndrome and multi-organ dysfunction associated with COVID-19 have been increasingly reported. We report a case of 31-week neonate of 1.292 kg confirmed with SARS-CoV-2 infection, at birth, born to a COVID positive mother, initially developed respiratory distress at birth and abrupt progression to severe distress and later developed pneumothorax and hyper-inflammation (MIS-N). Respiratory support, corticosteroids, enoxaparin, antimicrobials, and other preterm care were given, and finally recovered and discharged after 30 days (1.812 kg). This case highlights the severe presentation of COVID-19 in a pre-term neonate. To the best of our knowledge this is apparently the youngest covid survivor till date reported in world. Clinical data on COVID-19 in new-born is extremely limited, so it is important to understand that these conclusions are based on limited data and our understanding will continue to evolve.

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COVID-19-Related Potential Multisystem Inflammatory Syndrome in Childhood in a Neonate Presenting as Persistent Pulmonary Hypertension of the Newborn

Abstract: TABLE 1. Laboratory Results on Admission Laboratory Test Results White-blood cell count 7310 cells/mm 3 Neutrophil count 4760 cells/mm 3 Lymphocyte count 2060 cells/mm 3 Monocyte count 430 cells/mm 3 Hemoglobin 13 g/L Platelet count

Cited by 50 publications

References 8 publications

Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series

Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series

Multisystem Inflammatory Syndrome in Children: Diagnostic Markers and Features of Pharmacotherapy

Multisystem inflammatory syndrome-neonate: youngest COVID survivor

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