Emerg Infect Dis. 2022 Mar;28(3):510-517. doi: 10.3201/eid2803.211735. Epub 2022 Feb 9.
Severe coronavirus disease in neonates is rare. We analyzed clinical, laboratory, and autopsy findings from a neonate in the United States who was delivered at 25 weeks of gestation and died 4 days after birth; the mother had asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and preeclampsia. We observed severe diffuse alveolar damage and localized SARS-CoV-2 by immunohistochemistry, in situ hybridization, and electron microscopy of the lungs of the neonate. We localized SARS-CoV-2 RNA in neonatal heart and liver vascular endothelium by using in situ hybridization and detected SARS-CoV-2 RNA in neonatal and placental tissues by using reverse transcription PCR. Subgenomic reverse transcription PCR suggested viral replication in lung/airway, heart, and liver. These findings indicate that in utero SARS-CoV-2 transmission contributed to this neonatal death.
新生儿严重冠状病毒病罕见。我们分析了美国一名 25 周早产儿的临床、实验室和尸检结果，该患儿出生后 4 天死亡；母亲患有无症状严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染和先兆子痫。我们通过免疫组化、原位杂交和电镜观察到新生儿肺部弥漫性肺泡损伤和局灶性 SARS-CoV-2。我们通过原位杂交在新生儿心脏和肝脏血管内皮中定位 SARS-CoV-2 RNA，并通过逆转录 PCR 在新生儿和胎盘组织中检测到 SARS-CoV-2 RNA。亚基因组逆转录 PCR 提示病毒在肺/气道、心脏和肝脏中复制。这些发现表明，宫内 SARS-CoV-2 传播导致了这名新生儿的死亡。
