Lung ultrasound and neonatal COVID-19 pneumonia: A case report.

Abstract

Purpose: Severe Novel Coronavirus Disease 2019 (COVID-19) infection in neonates is possible but reports are scarce. Lung ultrasound (LUS) has been reported useful for triaging, diagnosing, and monitoring of patients with COVID-19.Material and methods: We describe SARS-CoV-2 confirmed infection on a term newborn that developed pneumonia and pulmonary hypertension requiring mechanical ventilation. Ultrasonographic follow up of COVID-19 pneumonia and pulmonary hypertension was carried out. Results: A 3,140-g male infant born at 40.3 weeks’ gestation developed progressive respiratory distress requiring mechanical ventilation. Real time PCR respiratory tract swabs for SARS COV 2 sampled on day 3 were positive for the baby and both parents. Lung ultrasound showed an irregular pleural line (shred sign), multiple confluent B-lines and bilateral ≥ 0.5 cm subpleural consolidations. Improvement of the lung and cardiac conditions were documented by ultrasound. Conclusion: Our case represents a severe presentation of COVID-19 pneumonia with pulmonary hypertension requiring mechanical ventilation. LUS showed to be useful for diagnosis and follow up.

Synthesis and systematic review of reported neonatal SARS-CoV-2 infections

“…Only two neonatal infections were diagnosed by the presence of IgM in newborn blood 29,82 : these cases qualified as possible congenital and probable postpartum acquired infections, respectively, according to the classification system 16 ; all the other cases had at least one positive RT-PCR. Nine (5.1%) neonates required delivery room resuscitation 19,20,38,41,44,69,77,87 and 67 (38.3%) needed to be admitted to the NICU 17,18,20,27,31,33,35,36,38,41,44,45,[47][48][49][51][52][53][57][58][59]61,62,[64][65][66][69][70][71][72][73]77,[80][81][82][85][86][87]<...>…”

“…Clinical features of neonatal SARS-CoV-2 infections. Ninetyseven neonates presented with clinical features related to COVID-19: 18,20,[26][27][28]30,32,[34][35][36][38][39][40][41]44,45,[50][51][52]55,56,58,60,61,[65][66][67][70][71][72]77,78,80,81,[85][86][87][88]90 their distribution is shown in Table 3. Respiratory manifestations mainly consisted of signs of respiratory failure, such as tachypnoea, intercostal retractions, and rhinitis; neonatal ARDS was not diagnosed in any case.…”

“…Inflammatory markers (Creactive protein and procalcitonin) were increased in 15 (15.5%) out of 97 neonates 20,27,38,40,43,45,49,59,70,72,[80][81][82]88 . Lung imaging was abnormal in 62 (64%) out of 97 neonates and consisted of an interstitialalveolar pattern at lung ultrasound or chest X-ray and ground-glass opacities at CT-scan 17,19,21,23,27,29,32,36,38,44,45,51,53,55,58,59,[64][65][66][69][70][71]73,[77][78][79][80]82,85,88,90 . One neonate presenting with neurological manifestations also showed bilateral gliosis of the deep white periventricular and subcortical matter, together with signs of cerebral vasculitis, which was not totally remitted at the hospital discharge 77 .…”

“…Our findings confirm that SARS-CoV-2 can infect neonates and that the majority of these infections occur 17 Case report France a PR 6 Good Aghdam 18 Case report Iran PR 4 Intermediate Alonso Diaz 19 Case report Spain PR 5 Intermediate Alzamora 20 Case report Peru PR 3 Intermediate Ayed 21 Case series Kuwait Preprint 1 Low Banerjee 22 Case series India PR 2 Low Barbero 23 Retrospective cohort study Spain PR n.a. Intermediate Buonsenso 24 Case series Italy PR 4 Intermediate Carosso 25 Case report Italy PR 4 Intermediate Chacon-Aguilar 26 Case report Spain PR 5 Intermediate Coronado Munoz 27 Case report USA PR 4 Intermediate Demirjian 28 Case report UK PR 4 Intermediate Dong 29 Case report China PR 6 Good Dumpa 30 Case report USA PR 6 Good Eghbalian 31 Case report Iran PR 4 Intermediate Feng 32 Case series China PR 3 Intermediate Fenizia 33 Case series Italy PP 5 Intermediate Ferrazzi 34 Case series Italy PR 1 Low Garazzino 35 Case series Italy PR 2 Low Gonzales Brabin 36 Case report Spain PR 3 Intermediate Gordon 37 Case report UK PR 2 Low Gregorio-Hernandez 38 Case series Spain PR 5 Intermediate Groß 39 Case series Germany PR 5 Intermediate Han 40 Case report South Korea PR 6 Good Hantoushzadeh 41 Case series Iran PR 6 Good Hasan 42 Case series Bangladesh Preprint 6 Good Hu 43 Case series China PR 6 Good Ibarra Rios 44 Case report Mexico Preprint 5 Intermediate Kanburoglu 45 Case report Turkey PR 1 Low Kayem 46 Case series France PR 1 Low Kirtsman 47 Case report Canada PR 6 Good Knight 48 Retrospective cohort study UK PR n.a. n.a.…”