Multisystem inflammatory syndrome-neonate: youngest COVID survivor

Abstract

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.