Pulmonary Artery Thrombosis in a Newborn With Severe Coronavirus Disease 2019

Schulze, Clara; Alarcón-Andrade, Gonzalo; Valenzuela, Gonzalo; Ferreiro, Myriam; Cavagnaro, Agustín; García-Salum, Tamara; Gutiérrez, Monserrat; Medina, Rafael

doi:10.1097/inf.0000000000003131

Cited by 3 publications

(4 citation statements)

References 4 publications

(5 reference statements)

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“…The clinical manifestations, reported in 9 cases, included hemodynamic compromise in 7 cases (54%), gastrointestinal symptoms in 3 (23%), and dyspnea with a decreased level of consciousness in 1 (8%). ICT was associated with PE in 3 children ( 7 , 15 , 19 ), and with both AIS and DVT in 1 ( 21 ).…”

Section: Resultsmentioning

confidence: 96%

“…Within the VTEs group, PEs were the most frequent events (39/157 events, 25%), followed by DVT (29 events, 18%), CVST (13 events, 8%), and SVT in 4 (3%). Notably, 10 patients had multiple types of VTEs and four had both venous and arterial thrombosis; among them, a newborn with a thrombus localized both in the right pulmonary artery and into the right ventricle was described ( 15 ).…”

Section: Resultsmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

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

et al. 2022

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“…In our experience, we already showed how SARS-CoV-2 presence correlated with vascular damage and thrombosis in three patients tested negative for SARS-CoV-2 (12). Similarly, a 27 days-old newborn with pulmonary artery thrombosis associated with severe COVID-19 10.3389/fmed.2023.1127529 had tested negative for SARS-CoV-2 RT-PCR in nasopharyngeal swab, but positive in endotracheal aspirate (14).…”

Section: Discussionmentioning

confidence: 79%

Case report: Tissue positivity for SARS-CoV-2 in a preterm born infant death of thrombosis: possible intrauterine transmission

et al. 2023

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Intrauterine transmission of SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona Virus 2) is still matter of debate among scientists and there is limited information concerning this aspect of research. This could lead to severe complications of the growing fetus and, theoretically, of the newborn as well. We report the case of a male infant of 1,100 grams, born at 27th week of gestation to a SARS-CoV-2 mother, tested negative for viral detection at delivery. He was immediately admitted to neonatal Intensive Care Unit (ICU) for severe complications, where he died after 37 days by pulmonary embolism and thrombosis of the superior vena cava. After autopsy, SARS-CoV-2 N-protein and Spike RBD were detected in several tissues, particularly in the esophagus, stomach, spleen, and heart, with a significantly higher H-Score than the placenta. In conclusion, immunohistochemical analysis demonstrated SARS-CoV-2 NP and Spike RBD positivity in different tissues suggesting a possible intrauterine transmission. Newborn thrombo-embolism could be a complication of SARS-CoV-2 infection as observed in adult patients.

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“…Therefore, the neonate required two courses of alteplase, which improved his clinical condition. Many factors could have contributed to the development of the disease, but SARS-CoV-2 infection might be treated as a condition promoting the thrombotic event [30]. However, to the best of our knowledge, no case report has been published where pulmonary thrombosis occurred in utero and caused circulatory failure in the fetus.…”

Section: Discussionmentioning

confidence: 99%

Prenatal and Neonatal Pulmonary Thrombosis as a Potential Complication of SARS-CoV-2 Infection in Late Pregnancy

Abdulaziz-Opiela

Sobieraj

Sibrecht

et al. 2023

IJMS

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Neonatal venous thrombosis is a rare condition that can be iatrogenic or occur due to viral infections or genetic mutations. Thromboembolic complications are also commonly observed as a result of SARS-CoV-2 infections. They can affect pediatric patients, especially the ones suffering from multisystem inflammatory syndrome in children (MIS-C) or multisystem inflammatory syndrome in neonates (MIS-N). The question remains whether the maternal SARS-CoV-2 infection during pregnancy can lead to thromboembolic complications in fetuses and neonates. We report on a patient born with an embolism in the arterial duct, left pulmonary artery, and pulmonary trunk, who presented several characteristic features of MIS-N, suspecting that the cause might have been the maternal SARS-CoV2 infection in late pregnancy. Multiple genetic and laboratory tests were performed. The neonate presented only with a positive result of IgG antibodies against SARS-CoV-2. He was treated with low molecular weight heparin. Subsequent echocardiographic tests showed that the embolism dissolved. More research is necessary to evaluate the possible neonatal complications of maternal SARS-CoV-2 infection.

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Pulmonary Artery Thrombosis in a Newborn With Severe Coronavirus Disease 2019

Cited by 3 publications

References 4 publications

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

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

Case report: Tissue positivity for SARS-CoV-2 in a preterm born infant death of thrombosis: possible intrauterine transmission

Prenatal and Neonatal Pulmonary Thrombosis as a Potential Complication of SARS-CoV-2 Infection in Late Pregnancy

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