Childhood Interstitial Lung Disease Masquerading as Post COVID-19 Respiratory Distress

Childhood interstitial lung diseases (chILD) are a set of illnesses affecting the bronchoalveolar spaces and the cellular compartment of the lungs. In the neonatal period, they are mainly classified under disorders of development, growth, surfactant dysfunction, and others of unknown causes distinctive in infancy. One of the most common causes is the deficiency of triphosphate binding cassette transporter A3 (ABCA3) protein. It activates impairment in the function of surfactants, resulting in respiratory distress in term infants, which is lethal in many cases and in some other cases leads to interstitial lung disease. We herein present a case of a 14-month-old boy with a peculiar case of ABCA3 protein deficiency that was masked at birth with COVID-19 infection and then presented with shortness of breath and poor feeding at the age of three months. The child was treated with macrolides, steroids, and hydroxychloroquine, with which he survived beyond the age of one year.