CHEST Guidelines-Clinical-and-Imaging-Features-of-COVID-19-in-a-Neo

Clinical-and-Imaging-Features-of-COVID-19-in-a-Neo

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This case report describes the clinical and imaging features of COVID-19 in a neonate, possibly the youngest patient globally at the time of diagnosis. The mother, a 34-year-old woman from Wuhan, China, presented at the hospital with mild fever and labor pains. Despite no clear exposure history, she was suspected to have COVID-19 based on symptoms and CT imaging, which revealed ground-glass opacities typical of viral pneumonia, and a positive PCR test for SARS-CoV-2.<br /><br />A caesarean section was performed with precautions to prevent nosocomial infection. The neonate weighed 3.25 kg at birth, exhibiting normal oxygen saturation and an Apgar score of 8-9. Initial chest radiography showed no abnormalities, but a subsequent PCR test of the oropharyngeal swab was positive for SARS-CoV-2, confirming COVID-19. The neonate's initial clinical presentation was mild, sans fever or cough.<br /><br />Over the next four days, mild changes appeared in the neonate's chest radiography, showing small bronchovascular shadows and ground-glass opacity in the right lower lobe. PCR tests remained positive until day 17 after birth when tests on oropharyngeal and anal swabs turned negative. Despite the infection, the neonate's weight increased steadily, and he experienced only mild, transient physiological jaundice. The baby was discharged after his condition stabilized.<br /><br />This case highlights the lack of evidence for vertical transmission of COVID-19 from mother to fetus during late pregnancy, although infections in neonates shortly after birth raise questions about potential transmission routes. The neonate's mild symptoms contrast with typical adult presentations, possibly due to an immature immune response or brief disease duration, underlining the need for neonatologists to monitor newborns of infected mothers carefully.

Keywords

COVID-19

neonate

SARS-CoV-2

vertical transmission

ground-glass opacity

PCR test

Wuhan

neonatologist

viral pneumonia

nosocomial infection