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一名早产新生儿新冠病毒感染合并新生儿败血症的管理——病例报告

Management of neonatal sepsis with COVID-19 infection in a premature newborn - A case report.

作者信息

Kaveh Mahbod, Sadatinejad Seyyed Mohsen

机构信息

Bahrami Children Hospital, Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Neonatal Nurs. 2023 Apr;29(2):409-412. doi: 10.1016/j.jnn.2022.07.028. Epub 2022 Aug 2.

Abstract

INTRODUCTION

Neonates appear to be less affected by COVID-19 than adults, yet COVID-19 has been a challenge for all medical specialties, including neonatal intensive care unit (NICU) specialists. Unfortunately, current knowledge about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is limited. This case report explains how COVID-19 neonatal sepsis was treated with immunomodulatory agents.

CASE PRESENTATION

In this case, we present a premature male newborn who was ill. He was born to a mother with a negative nasopharyngeal swab test for SARS-CoV-2. On the fifth day of life, the baby developed respiratory distress, and a nasopharyngeal swab test for SARS-CoV-2 tested positive. The baby was Intubated, and intratracheal surfactant was administered. The infant was treated with intravenous immunoglobulin (IVIg) and corticosteroids for 14 days.

PATIENT'S DEMOGRAPHICS: Age: under 1 month, Sex: Male, Ethnicity: Iranian.

CONCLUSION

The basics of treatment for neonatal COVID-19 is supportive care. Some studies have treated infants with various drugs such as Hydroxychloroquine, Favipiravir, and Remedsivir; however, in our case, a 5-day-old baby boy was treated with corticosteroids and IVIg. We achieved good outcomes after 2 weeks of treatment with dexamethasone 0.3 mg/kg per day and IVIg 2 g/kg/day (for 3 days). It appears that these treatments, along with adjuvant ventilation and the administration of endotracheal surfactant, can improve a patient's general condition.

摘要

引言

新生儿似乎比成年人受新冠病毒病(COVID-19)的影响更小,但COVID-19对包括新生儿重症监护病房(NICU)专家在内的所有医学专科来说都是一项挑战。不幸的是,目前关于严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染的知识有限。本病例报告解释了如何用免疫调节药物治疗COVID-19新生儿败血症。

病例介绍

在本病例中,我们介绍了一名患病的早产男婴。他的母亲鼻咽拭子SARS-CoV-2检测呈阴性。出生后第5天,婴儿出现呼吸窘迫,鼻咽拭子SARS-CoV-2检测呈阳性。婴儿接受了气管插管,并给予了气管内表面活性剂。婴儿接受了静脉注射免疫球蛋白(IVIg)和皮质类固醇治疗14天。

患者人口统计学资料

年龄:1个月以下,性别:男,种族:伊朗人。

结论

新生儿COVID-19的基本治疗方法是支持性护理。一些研究用羟氯喹、法匹拉韦和瑞德西韦等各种药物治疗婴儿;然而,在我们的病例中,一名5天大的男婴接受了皮质类固醇和IVIg治疗。我们在每天0.3 mg/kg地塞米松和每天2 g/kg IVIg(共3天)治疗2周后取得了良好效果。看来这些治疗方法,连同辅助通气和气管内表面活性剂的给药,可以改善患者的一般状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a080/9343744/198d40ca5a92/gr1_lrg.jpg

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