COVID-19 infected neonate presenting with cytokine storm and sepsis

Authors

  • Mallesh Kariyappa Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Sahana Devadas Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Aparna Dutt Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Varun Govindarajan Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India http://orcid.org/0000-0002-3323-2030

DOI:

https://doi.org/10.18203/2349-3291.ijcp20212492

Keywords:

COVID-19, SARS-CoV19, Neonatal sepsis, Cytokine storm

Abstract

COVID-19, a clinical syndrome caused by the coronavirus (SARS-CoV-2) became a pandemic following an outbreak of viral pneumonitis, first identified in Wuhan, China. The disease manifestations vary ranging from mild upper respiratory tract infection to severe pneumonitis, acute respiratory distress syndrome (ARDS) and even death. Although most of the neonatal cases are asymptomatic, rarely, they can present with cytokine storm mimicking with similar features of sepsis. This is a case report of SARS-CoV19 positive neonate presenting with sepsis and cytokine storm, 5-day old baby born to SARS-COVID 19 positive mother presented with fever and investigations showed elevated total counts with neutrophilic predominance, thrombocytopenia suggestive of sepsis and increased inflammatory markers suggestive of cytokine storm. Blood culture was sent and baby was started on intravenous antibiotics. In view of cytokine storm intravenous dexamethasone 0.5 mg/kg/day was given intravenously for 5 days. Neonate recovered from illness after 1 week as evidenced clinically and and by the fall in inflammatory markers before discharge. This report opens the possibility of having both sepsis and cytokine storm in a SARS-CoV19 positive neonate.

Author Biographies

Mallesh Kariyappa, Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India

Professor and HOD, Department of Paediatrics

Sahana Devadas, Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India

Professor and Neonatologist, Department of Paediatrics

Aparna Dutt, Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India

Junior Resident, Department of Paediatrics

Varun Govindarajan, Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India

Junior Resident, Department of Paediatrics

References

Zeng L, Xia S, Yuan W, Yan K, Xiao F, Shao J, Zhou W. Neonatal early-onset infection with SARS-CoV-2 in 33 neonates born to mothers with COVID-19 in Wuhan, China. JAMA Pediatr. 2020;174(7):722-5.

Alzamora MC, Paredes T, Caceres D, Webb CM, Valdez LM, La Rosa M. Severe COVID-19 during pregnancy and possible vertical transmission. Am J Perinatol. 2020;37(08):861-5.

Lu Q, Shi Y. Coronavirus disease (COVID-19) and neonate: what neonatologist needs to know. J Med Virol. 2020;92(6):564-7.

Ragab D, Salah Eldin H, Taeimah M, Khattar R, Salem R. The COVID-19 Cytokine Storm; What We Know So Far. Front Immunol. 2020;11:1446.

Shimizu M. Clinical features of cytokine storm syndrome. In: Cron R, Behrens E editors. Cytokine Storm Syndrome. Cham: Springer. 2019;31-42.

Khaertynov S, Boichuk SV, Khaiboullina SF, Anokhin VA, Andreeva AA, Lombardi VC et al. Comparative Assessment of Cytokine Pattern in Early and Late Onset of Neonatal Sepsis. J Immunol res. 2017;8601063:8.

Ng PC. Diagnostic markers of infection in neonates, Archives of Disease in Childhood-Fetal and Neonatal Edition. 2004;89:F229-35.

Martinez MA. Compounds with therapeutic potential against novel respiratory 2019 coronavirus. Antimicrob. Agents Chemother. 2020;64(5):e00399-20.

Recovery Collaborative Group, Horby P, Lim WS. Dexamethasone in hospitalized patients with COVID-19-preliminary report. N Engl J Med. 2020;384(8):693-704.

Wang Y, Jiang W, He Q. A retrospective cohort study of methylprednisolone therapy in severe patients with COVID-19 pneumonia. Signal Transduct Target Ther. 2020;5(1):57.

Downloads

Published

2021-06-24

Issue

Section

Case Reports