这项研究的目的是描述作为COVID-19临床体征的呼吸暂停的年轻婴儿的临床特征。我们报告了4例婴儿在我们的PICU中需要呼吸支持的病例,这些婴儿患有严重的COVID-19并伴有复发性呼吸暂停。此外,我们回顾了有关COVID-19和校正年龄≤2个月婴儿呼吸暂停的文献.总共包括17名年轻婴儿。总的来说,在大多数情况下(88%),呼吸暂停是COVID-19的初始症状,在两个病例中,3-4周后复发。关于神经学检查,大多数孩子接受了颅骨超声检查,虽然少数人接受了脑电图记录,神经影像学,还有腰椎穿刺.一个孩子在脑电图上显示出脑病的迹象,进一步的神经系统检查结果正常。在脑脊液中从未发现SARS-CoV-2。十个孩子需要入住重症监护室,其中五个需要插管和三个无创通气。对于其余儿童,侵入性较小的呼吸支持就足够了。8名儿童接受了咖啡因治疗。所有患者均完全恢复。结论:COVID-19期间复发性呼吸暂停的年轻婴儿通常需要呼吸支持并接受广泛的临床检查。即使进入重症监护室,他们通常也会完全康复。需要进一步的研究来更好地确定这些患者的诊断和治疗策略。已知情况:•尽管COVID-19在婴儿中的病程通常是温和的,他们中的一些人可能会患上更严重的疾病,需要重症监护支持。呼吸暂停可能是COVID-19的临床症状。新增内容:•COVID-19期间出现呼吸暂停的婴儿可能需要重症监护支持,但他们通常表现出疾病的良性过程和完全康复。
The objective of this study is to describe the clinical features of young infants with apneas as a clinical sign of COVID-19. We reported the cases of 4 infants who needed respiratory support in our PICU for a severe course of COVID-19 complicated with recurrent apneas. Moreover, we conducted a review of the literature about COVID-19 and apneas in infants ≤ 2 months of corrected age. A total of 17 young infants were included. Overall, in most of the cases (88%), apnea was an initial symptom of COVID-19, and in two cases, it recurred after 3-4 weeks. Regarding neurological workup, most children underwent a cranial ultrasound, while a minority underwent electroencephalography registration, neuroimaging, and lumbar punctures. One child showed signs of encephalopathy on electroencephalogram, with further neurological workup resulting normal. SARS-CoV-2 was never found in the cerebrospinal fluid. Ten children required intensive care unit admission, with five of them needing intubation and three non-invasive ventilation. A less invasive respiratory support was sufficient for the remaining children. Eight children were treated with caffeine. All patients had a complete recovery. Conclusion: Young infants with recurrent apneas during COVID-19 usually need respiratory support and undergo a wide clinical work-up. They usually show complete recovery even when admitted to the intensive care unit. Further studies are needed to better define diagnostic and therapeutic strategies for these patients. What is Known: • Although the course of COVID-19 in infants is usually mild, some of them may develop a more severe disease needing intensive care support. Apneas may be a clinical sign in COVID-19. What is New: • Infants with apneas during COVID-19 may require intensive care support, but they usually show a benign course of the disease and full recovery.