Aortic thrombosis in a neonate with COVID-19-related fetal inflammatory response syndrome requiring amputation of the leg: a case report

Amonkar, Priyanka; Gavhane, Jeetendra; Kharche, Suhas N.; Kadam, Sameer; Bhusare, Dattatray

doi:10.1080/20469047.2021.1968596

Cited by 19 publications

(23 citation statements)

References 14 publications

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“…13 Diggikar et al reported a case of early neonatal acute SARS-CoV-2 infection followed by a multisystem inflammatory response. 14 These and the other reports outlined in ►Table 1, [15][16][17][18][19][20][21] suggesting an overlap between four possible manifestations of COVID-19 during the neonatal period (►Table 2).…”

mentioning

confidence: 68%

Multisystem Inflammatory Syndrome in Neonates following Maternal SARS-CoV-2 COVID-19 Infection

et al. 2021

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Children present with multisystem inflammatory syndrome (MIS-C), a post-infectious syndrome presenting a few weeks following an acute SARS CoV-2 infection. A few case reports of neonates presenting with a similar syndrome following maternal infection have been reported. This article summarizes the current literature and outlines the controversies surrounding the diagnosis and management of MIS-C in neonates (MIS-N).

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confidence: 68%

Multisystem Inflammatory Syndrome in Neonates following Maternal SARS-CoV-2 COVID-19 Infection

et al. 2021

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“…The total number of patients with ATs was 59, including 54 with AIS, 2 with splenic AT ( 10 ), 2 with aortic thrombosis in the abdominal ( 18 ), and thoracic tract ( 19 ), respectively, and 1 with coronary thrombosis ( 20 ) ( Supplementary Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Nine patients (6%) had persistent neurological sequelae (mostly secondary to AIS), including hemiparesis in 3 children, facial palsy, dysarthria, and aphasia in 2, and weakness in 1. A neonate had abdominal aortic thrombosis requiring leg amputation ( 18 ). One patient had a major bleeding event, an adolescent had a premature delivery.…”

Section: Resultsmentioning

confidence: 99%

Thromboembolic complications in children with COVID-19 and MIS-C: A narrative review

et al. 2022

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COVID-19 and multisystem inflammatory syndrome in children (MIS-C) have been associated with a higher incidence of hypercoagulability and thromboembolic events (TEs), even in children, leading to relevant morbidity, and mortality. However, our understanding of such complications in childhood is limited. To better understand the incidence, clinical manifestations, risk factors, and management of COVID-19 and MIS-C-related TEs in children, a review of the current literature and a brief update on pathophysiology are given. Sixty-two studies, describing 138 patients with TEs associated with COVID-19 or MIS-C, were included. The overall number of TEs was 157, as 16 patients developed multiple TEs: venous TEs represented the majority (54%), followed by arterial thrombosis (38%, mainly represented by arterial ischemic stroke-AIS), and intracardiac thrombosis (ICT) (8%). Within the venous TEs group, pulmonary embolism (PE) was the most frequent, followed by deep venous thrombosis, central venous sinus thrombosis, and splanchnic venous thrombosis. Notably, 10 patients had multiple types of venous TEs, and four had both venous and arterial thrombosis including a newborn. Most of them (79 cases,57%) had at least one predisposing condition, being obesity the most frequent (21%), especially in patients with PE, followed by malignancy (9%). In 35% of cases, no data about the outcome were available About one-third of cases recovered, 12% improved at discharge or follow-up, and 6% had persistent neurological sequelae. The mortality rate was 12%, with death due to comorbidities in most cases. Most fatalities occurred in patients with arterial thrombosis. Pediatricians should be aware of this life-threatening possibility facing children with SARS-CoV-2 infection or its multisystemic inflammatory complication, who abruptly develop neurological or respiratory impairment. A prompt intensive care is essential to avoid severe sequelae or even exitus.

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“…98 Neonatal cases of MIS-C (Neonatal MIS-C, or MIS-N) are rarely reported, and their clinical presentation is not well-established. [99][100][101][102][103] Orlanski-Meyer et al reported a 6-weekold infant with severe gastrointestinal symptoms, anemia, elevated D-dimers, ferritin, hypoalbuminemia, and thrombocytosis then thrombocytopenia. Echocardiography in this infant showed normal coronary arteries with mitral regurgitation.…”

Section: Neonates With Confirmed Covid-19 and Mis-cmentioning

confidence: 99%

“…102 The infant received intravenous Ig and corticosteroids, followed by clinical improvement. Other suspected case reports of MIS-N include a 33-week fetus with worsening pericardial effusion in a pregnant woman with previous COVID-19 infection, 101 a term neonate with COVID-19 related fetal inflammatory response syndrome with aortic thrombosis resulting in leg amputation, 99 and a fatal case of a 7-month-old, 26-week preterm infant following SARS-COV-2 infection. 100 Pawar et al 104 described a case series of 20 infants with MIS-N associated with maternal SARS-CoV-2.…”

Section: Neonates With Confirmed Covid-19 and Mis-cmentioning

confidence: 99%

Mother to Newborn Transmission of SARS-CoV-2 Infection: Evolution of Evidence in 1.5 Years of COVID-19 Pandemic

Gupta

Kamity²,

Sharma

et al. 2022

Am J Perinatol

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Coronavirus disease 2019 (COVID-19) pandemic caused significant mortality and morbidity in people of all age groups worldwide. Given the uncertainty regarding the mode of transmission and potential effects of COVID-19 on pregnant mothers and their newborns, guidelines for taking care of maternal–newborn dyads have evolved tremendously since the pandemic began. There has been an enormous influx of published materials regarding the outcomes of mothers and newborns. Still, multiple knowledge gaps regarding comprehensive information about risk to the mothers and newborns exist, which need to be addressed. Current evidence suggests that mothers with symptomatic COVID-19 infection are at increased risk of severe illness during pregnancy, with a higher need for respiratory support and premature deliveries. Neonates born to mothers with COVID-19 are at increased risk of needing intensive care; however, most newborns do well after birth. As new mutant variants arise, we need to be cautious while proactively understanding any new evolving patterns. All leading health authorities strongly recommend COVID-19 vaccination before or during pregnancy to reduce the risk of maternal morbidities and benefit from passing antibodies to newborns prenatally and via breastmilk. Additionally, there are racial, ethnic, and socioeconomic disparities in outcomes and vaccination coverage for pregnant women. This article summarizes the rapidly evolving evidence for the last 1.5 years and aims to help health care professionals care for mothers with COVID-19 and their newborns. Key Points

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Aortic thrombosis in a neonate with COVID-19-related fetal inflammatory response syndrome requiring amputation of the leg: a case report

Cited by 19 publications

References 14 publications

Multisystem Inflammatory Syndrome in Neonates following Maternal SARS-CoV-2 COVID-19 Infection

Multisystem Inflammatory Syndrome in Neonates following Maternal SARS-CoV-2 COVID-19 Infection

Thromboembolic complications in children with COVID-19 and MIS-C: A narrative review

Mother to Newborn Transmission of SARS-CoV-2 Infection: Evolution of Evidence in 1.5 Years of COVID-19 Pandemic

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