COVID-19 Associated With Life-Threatening Apnea in an Infant Born Preterm: A Case Report

Abstract

A pandemic linked to the new coronavirus strain (SARS-CoV-2) has been raging for several months. Pediatric populations are less impacted than adults, and critical respiratory diseases seem rare (1, 2). We report the case of an infant, who presented with life-threatening apneas at home requiring basic life support. SARS-CoV-2 was subsequently identified in the patient's nasopharyngeal aspirate. He did not present with bronchiolitis or hypoxic failure as described in severe forms of COVID−19. The outcome was favorable in a few hours. The occurrence of apneas is not uncommon during viral respiratory infections in early infancy; however, there are very few descriptions related to a documented SARS-CoV-2 respiratory tract infection. In light of this clinical case, it seems necessary to quickly bring up a potential COVID-19 contamination in infants admitted for life-threatening apnea, in order to properly report and isolate these patients to avoid further nosocomial dissemination of SARS-CoV-2.

Apnea in a Two-Week-Old Infant Infected with SARS-CoV-2 and Influenza B

“…Apnea occurs rarely in healthy full-term infants compared to preterm infants [ 13 ] with an incidence rate of one in 1000 [ 14 ]. Apnea presenting during the first weeks of life hints of “brief resolved unexplained event” (BRUE).…”

“…The history and physical examination of our patient met criteria for high-risk BRUE for age (<60 days) and duration of event (>one minute). Apnea associated with SARS-CoV-2 infection has been reported [ 13 , 16 , 17 ] and may be the presenting symptom [ 16 , 17 ]. The COVID-19 pandemic and season for epidemic respiratory illnesses resulted in screening for viral respiratory illnesses.…”

Cardiorespiratory alterations in a newborn ovine model of systemic viral inflammation

“… 20 Poly I:C induces TLR3 stimulation, which is especially involved in rhinovirus, coronavirus, influenza, and respiratory syncytial virus infection. 10 , 11 , 47 The latter frequently presents as severe cardiorespiratory events in the first weeks of life in both the full-term and preterm infant and has been suggested as an important triggering factor of sudden infant death syndrome. 13 , 15 …”

Among Young Infants With Uncomplicated COVID-19: Should We Broaden Diagnostic Tests for Infectious Causes of Apnea?

“…Among all patients (severe and nonsevere), there were no reports of apnea. To the best of our knowledge publications about COVID-19 associated apnea in infants are scarce 2 and published before the delta variant of SARS-CoV-2 became widespread.…”