Patrick-Esteve Jessica, Mumphrey Christy, Yu David, Masoumy Emily, Lawson Jeremy, Hebert David, Barkemeyer Brian
Department of Pediatrics-Division of Neonatology, Children's Hospital New Orleans, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA, United States.
Department of Surgery, Children's Hospital of New Orleans, Tulane University School of Medicine, New Orleans, LA, United States.
Front Pediatr. 2022 Aug 12;10:953122. doi: 10.3389/fped.2022.953122. eCollection 2022.
Coronavirus disease 2019 (COVID-19) was first reported to the World Health Organization (WHO) in December 2019 and has since unleashed a global pandemic, with over 518 million cases as of May 10, 2022. Neonates represent a very small proportion of those patients. Among reported cases of neonates with symptomatic COVID-19 infection, the rates of hospitalization remain low. Most reported cases in infants and neonates are community acquired with mild symptoms, most commonly fever, rhinorrhea and cough. Very few require intensive care or invasive support for acute infection. We present a case of a 2-month-old former 26-week gestation infant with a birthweight of 915 grams and diagnoses of mild bronchopulmonary dysplasia and a small ventricular septal defect who developed acute respiratory decompensation due to COVID-19 infection. He required veno-arterial extracorporeal membrane oxygenation support for 23 days. Complications included liver and renal dysfunction and a head ultrasound notable for lentriculostriate vasculopathy, extra-axial space enlargement and patchy periventricular echogenicity. The patient was successfully decannulated to conventional mechanical ventilation with subsequent extubation to non-invasive respiratory support. He was discharged home at 6 months of age with supplemental oxygen nasal cannula and gastrostomy tube feedings. He continues to receive outpatient developmental follow-up. To our knowledge, this is the first case report of a preterm infant during their initial hospitalization to survive ECMO for COVID-19.
2019年冠状病毒病（COVID-19）于2019年12月首次向世界卫生组织（WHO）报告，此后引发了全球大流行，截至2022年5月10日，病例超过5.18亿例。新生儿在这些患者中所占比例非常小。在报告的有症状COVID-19感染的新生儿病例中，住院率仍然很低。婴儿和新生儿中报告的大多数病例是社区获得性的，症状较轻，最常见的是发热、流涕和咳嗽。极少数需要重症监护或急性感染的侵入性支持。我们报告一例2个月大的前26周孕龄婴儿，出生体重915克，诊断为轻度支气管肺发育不良和小型室间隔缺损，因COVID-19感染出现急性呼吸代偿失调。他需要静脉-动脉体外膜肺氧合支持23天。并发症包括肝肾功能障碍以及头部超声检查显示有豆纹状血管病变、轴外间隙扩大和脑室周围散在回声增强。患者成功撤去体外膜肺氧合插管，改为常规机械通气，随后拔管改为无创呼吸支持。他6个月大时出院，在家中通过鼻导管吸氧和胃造瘘管喂养。他继续接受门诊发育随访。据我们所知，这是第一例在首次住院期间因COVID-19接受体外膜肺氧合治疗后存活的早产儿病例报告。
