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Extremely Preterm Infant Born to a Mother With Severe COVID-19 Pneumonia

Little is known about the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on pregnant women, fetuses, and neonates, especially when the virus is contracted early in pregnancy. The literature is especially lacking on the effects of SARS-CoV-2 on extremely preterm (<28 weeks...

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Autores principales: Easterlin, Molly C., De Beritto, Theodore, Yeh, Amy M., Wertheimer, Fiona B., Ramanathan, Rangasamy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7391423/
https://www.ncbi.nlm.nih.gov/pubmed/32723092
http://dx.doi.org/10.1177/2324709620946621
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author Easterlin, Molly C.
De Beritto, Theodore
Yeh, Amy M.
Wertheimer, Fiona B.
Ramanathan, Rangasamy
author_facet Easterlin, Molly C.
De Beritto, Theodore
Yeh, Amy M.
Wertheimer, Fiona B.
Ramanathan, Rangasamy
author_sort Easterlin, Molly C.
collection PubMed
description Little is known about the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on pregnant women, fetuses, and neonates, especially when the virus is contracted early in pregnancy. The literature is especially lacking on the effects of SARS-CoV-2 on extremely preterm (<28 weeks gestation) infants who have underdeveloped immune systems. We report the case of an extremely preterm, 25-week 5-days old infant, born to a mother with severe COVID-19 (coronavirus disease-2019) pneumonia. In this case, there is no evidence of vertical transmission of SARS-CoV-2 based on reverse transcription-polymerase chain reaction testing, despite extreme prematurity. However, it appears that severe maternal COVID-19 may have been associated with extremely preterm delivery, based on observed histologic chorioamnionitis. This is the first reported case of an extremely preterm infant born to a mother with severe COVID-19 pneumonia who required intubation, and was treated with hydroxychloroquine, azithromycin, remdesivir, tocilizumab, convalescent plasma, inhaled nitric oxide, and prone positioning for severe hypoxemic respiratory failure prior to and after delivery of this infant. The infant remains critically ill with severe respiratory failure on high-frequency ventilation, inotropic support, hydrocortisone for pressor-resistant hypotension, and inhaled nitric oxide for severe persistent pulmonary hypertension with a right to left shunt across the patent ductus arteriosus and foramen ovale. Pregnant women or women planning to get pregnant should take all precautions to minimize exposure to SARS-CoV-2 to decrease adverse perinatal outcomes.
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spelling pubmed-73914232020-08-07 Extremely Preterm Infant Born to a Mother With Severe COVID-19 Pneumonia Easterlin, Molly C. De Beritto, Theodore Yeh, Amy M. Wertheimer, Fiona B. Ramanathan, Rangasamy J Investig Med High Impact Case Rep Case Report Little is known about the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on pregnant women, fetuses, and neonates, especially when the virus is contracted early in pregnancy. The literature is especially lacking on the effects of SARS-CoV-2 on extremely preterm (<28 weeks gestation) infants who have underdeveloped immune systems. We report the case of an extremely preterm, 25-week 5-days old infant, born to a mother with severe COVID-19 (coronavirus disease-2019) pneumonia. In this case, there is no evidence of vertical transmission of SARS-CoV-2 based on reverse transcription-polymerase chain reaction testing, despite extreme prematurity. However, it appears that severe maternal COVID-19 may have been associated with extremely preterm delivery, based on observed histologic chorioamnionitis. This is the first reported case of an extremely preterm infant born to a mother with severe COVID-19 pneumonia who required intubation, and was treated with hydroxychloroquine, azithromycin, remdesivir, tocilizumab, convalescent plasma, inhaled nitric oxide, and prone positioning for severe hypoxemic respiratory failure prior to and after delivery of this infant. The infant remains critically ill with severe respiratory failure on high-frequency ventilation, inotropic support, hydrocortisone for pressor-resistant hypotension, and inhaled nitric oxide for severe persistent pulmonary hypertension with a right to left shunt across the patent ductus arteriosus and foramen ovale. Pregnant women or women planning to get pregnant should take all precautions to minimize exposure to SARS-CoV-2 to decrease adverse perinatal outcomes. SAGE Publications 2020-07-29 /pmc/articles/PMC7391423/ /pubmed/32723092 http://dx.doi.org/10.1177/2324709620946621 Text en © 2020 American Federation for Medical Research https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Easterlin, Molly C.
De Beritto, Theodore
Yeh, Amy M.
Wertheimer, Fiona B.
Ramanathan, Rangasamy
Extremely Preterm Infant Born to a Mother With Severe COVID-19 Pneumonia
title Extremely Preterm Infant Born to a Mother With Severe COVID-19 Pneumonia
title_full Extremely Preterm Infant Born to a Mother With Severe COVID-19 Pneumonia
title_fullStr Extremely Preterm Infant Born to a Mother With Severe COVID-19 Pneumonia
title_full_unstemmed Extremely Preterm Infant Born to a Mother With Severe COVID-19 Pneumonia
title_short Extremely Preterm Infant Born to a Mother With Severe COVID-19 Pneumonia
title_sort extremely preterm infant born to a mother with severe covid-19 pneumonia
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7391423/
https://www.ncbi.nlm.nih.gov/pubmed/32723092
http://dx.doi.org/10.1177/2324709620946621
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