背景:我们报告了一例产前冠状病毒疾病2019,该疾病在出生后6天演变成严重的肺炎,并伴有多器官衰竭的迹象,一位患有无症状冠状病毒病的母亲2019年。
方法:在生命的第11分钟,我们来自非洲-加勒比的患者出现呼吸困难,有轻度挣扎的迹象;Silverman指数评分为3分。胸部X线检查显示双侧混浊与呼吸窘迫综合征一致。在生命的第六天,胸部计算机断层扫描扫描显示磨玻璃双侧实质病变(10-20%),与冠状病毒疾病2019型感染兼容。同时,新生儿出现多器官功能衰竭(肝脏和心脏酶水平升高)的迹象。她用阿奇霉素(20mg/kg/天)治疗5天。所有体征在第12天完全恢复。实时聚合酶链反应结果在生命的前30分钟为阳性,提示产前传播。我们的患者一直随访到2岁,并且发育良好,没有后遗症。
结论:本病例报告显示了2019年孕产妇无症状冠状病毒病与严重新生儿肺部受累之间的不相容性。我们强调需要保持警惕,避免错过2019年最严重形式的新生儿冠状病毒疾病。
BACKGROUND: We report a case of prenatal coronavirus disease 2019, which evolved 6 days after birth into severe pneumonia with signs of multiple organ failure, in a mother with asymptomatic coronavirus disease 2019.
METHODS: At minute 11 of life, our patient from Afro-Caribbean had polypnea with mild signs of struggle; Silverman\'s index was scored at three. Chest radiography showed bilateral opacities consistent with respiratory distress syndrome. On the 6th day of life, a thoracic computed tomography scan showed bilateral parenchymatous lesions (10-20%) in ground glass, compatible with coronavirus disease 2019-type infection. At the same time, the neonate showed signs of multiple organ failure (elevated liver and cardiac enzyme levels). She was treated with azithromycin (20 mg/kg/day) for 5 days. All the signs recovered fully by day 12. Real-time polymerase chain reaction results were positive in the first 30 min of life, suggesting prenatal transmission. Our patient has been followed until 2 years old and is developing well with no sequelae.
CONCLUSIONS: This case report demonstrates the incompatibility between maternal asymptomatic coronavirus disease 2019 and severe neonatal lung involvement. We emphasize the need for vigilance to avoid missing the most severe forms of neonatal coronavirus disease 2019.