Introduction. The clinical course of premature infants born to mothers with
coronavirus disease 2019 (COVID-19) has not been well characterized. The aim
of this paper was to report a complicated clinical course with pulmonary air
leak syndrome (pneumomediastinum and pneumothorax) in a premature infant
born to mother with COVID-19. Case outline. The patient was a male infant
born at 35 weeks of gestation. The mother had confirmed coronavirus
pneumonia 6 days prior to delivery. At approximately 25 hours of age, chest
X-ray showed pneumomediastinum, giving the classic ?spinnaker sail? sign.
After intubation, chest X-ray showed the typical ?angel wing? sign, which
represents pneumomediastinum and bilateral pneumothorax (pulmonary air leak
syndrome). Conclusion. Based on the presented case, we believe that the
mother's COVID-19 infection is an additional risk factor for the occurrence
of pulmonary air leaks in the infant. To confirm this hypothesis as well as
explain the exact pathophysiology of air leakage in COVID-19, larger,
prospective, and well-designed studies are needed.