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© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Coronavirus disease 2019 (COVID-19), a condition associated with SARS-CoV-2, typically results in mild infection in infants and children. However, children with risk factors such as chronic lung disease and immunosuppression have higher risk of severe illness from COVID-19. We report a case of a 27-week-gestation extremely premature infant born to a mother with COVID-19 infection. The infant, initially treated for surfactant deficiency, developed worsening hypoxic respiratory failure on the fifth day of life requiring escalating ventilatory support, an elevated level of C-reactive protein, thrombocytopenia, and an elevated level of d-dimer. The infant was positive for SARS-CoV-2 by RT-PCR from Day 1 to Day 42 of his life. The infant responded to a seven-day course of dexamethasone with a gradually decreasing oxygen requirement and could be extubated to non-invasive ventilation by the end of the fifth week after birth. The infant is currently on home oxygen by nasal cannula. Prolonged shedding of the virus may be a unique feature of the disease in premature infants. Extreme prematurity, immature lungs, and an immunocompromised status may predispose these infants to severe respiratory failure and a prolonged clinical course. Instituting appropriate COVID-19 protocols to prevent the spread of the disease in the neonatal intensive care unit (NICU) is of utmost importance. Infection with SARS-CoV-2 may have implications in the management of extremely premature infants in the NICU.

Details

Title
Respiratory Failure in an Extremely Premature Neonate with COVID-19
Author
Kumar, Vasantha H S 1   VIAFID ORCID Logo  ; Prasath, Arun 1 ; Blanco, Clariss 1 ; Kenney, Patrick O 2 ; Ostwald, Christina M 3 ; Meyer, Tracy S 3 ; Clementi, Cara F 4 ; Maciejewski, Richard 4 ; Wilby, Mark T 4 ; Reynolds, Anne Marie 1 ; Hpa, N Ja 1 ; Yu, Karl O A 1   VIAFID ORCID Logo 

 Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA; [email protected] (A.P.); [email protected] (C.B.); [email protected] (P.O.K.); [email protected] (A.M.R.); [email protected] (N.J.H.); [email protected] (K.O.A.Y.) 
 Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA; [email protected] (A.P.); [email protected] (C.B.); [email protected] (P.O.K.); [email protected] (A.M.R.); [email protected] (N.J.H.); [email protected] (K.O.A.Y.); Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA 
 Division of Infection Prevention, John R. Oishei Children’s Hospital, Buffalo, NY 14203, USA; [email protected] (C.M.O.); [email protected] (T.S.M.) 
 Department of Pathology and Laboratory Medicine, Kaleida Health, Buffalo, NY 14203, USA; [email protected] (C.F.C.); [email protected] (R.M.); [email protected] (M.T.W.) 
First page
477
Publication year
2021
Publication date
2021
Publisher
MDPI AG
e-ISSN
22279067
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2544674623
Copyright
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.