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CC BY-NC-ND 4.0 · AJP Rep 2021; 11(01): e49-e53
DOI: 10.1055/s-0041-1726020
Case Report

Pneumothorax in Neonates Born to COVID-19–Positive Mothers: Fact or Fortuity?

Ranjith Kamity 
1   Division of Neonatology, Department of Pediatrics, NYU Langone Hospital–Long Island, NYU Long Island School of Medicine, Mineola, New York
,
Amrita Nayak 
1   Division of Neonatology, Department of Pediatrics, NYU Langone Hospital–Long Island, NYU Long Island School of Medicine, Mineola, New York
,
Vikramaditya Dumpa 
1   Division of Neonatology, Department of Pediatrics, NYU Langone Hospital–Long Island, NYU Long Island School of Medicine, Mineola, New York
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Abstract

Neonates born to mothers with coronavirus disease 2019 (COVID-19) have been largely asymptomatic based on initial reports. All neonates born to mothers with COVID-19 have tested negative for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in our institution (published data as of April 12, 2020). As novel presentations of COVID-19, such as multisystem inflammatory syndrome in children are being increasingly reported, we raise the possibility of increased incidence of pneumothorax in neonates born to SARS-CoV-2–positive mothers. Two recently described neonates with COVID-19 infection were noted to have pneumothoraces. We describe two SARS-CoV-2–negative neonates born to COVID-19–positive mothers at 38 and 33 weeks, respectively, admitted to our neonatal intensive care unit for respiratory distress and subsequently developed pneumothoraces. As diverse clinical presentations in various age groups are being described, it becomes difficult to differentiate the increased incidence of complications related to an underlying illness, from COVID-19–related illness. It remains to be seen if neonates with in utero exposure to SARS-CoV-2 have an elevated inflammatory response with pneumonitis and exaggerated lung disease, similar to adult COVID-19 patients, due to in utero exposure.

Keywords

COVID-19 - coronavirus disease 2019 - neonate - pneumothorax - SARS-CoV-2 - vertical transmission

Authors' Contribution

Ranjith Kamity conceptualized this manuscript and wrote the initial draft of the manuscript. Vikramaditya Dumpa and Ranjith Kamity obtained parental consent. All authors performed literature search, collected patient data, revised, reviewed, and accepted the final version of the manuscript as submitted.


Financial Disclosure

The authors have no financial relationships relevant to this article to disclose. No funding was secured for this manuscript.




Publication History

Received: 22 May 2020

Accepted: 14 January 2021

Article published online:
23 March 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Zeng L, Xia S, Yuan W. et al. Neonatal early-onset infection with SARS-CoV-2 in 33 neonates born to mothers with COVID-19 in Wuhan, China. JAMA Pediatr 2020; 174 (07) 722-725
    CrossrefPubMedGoogle Scholar
  • 2 Vintzileos WS, Muscat J, Hoffmann E. et al. Screening all pregnant women admitted to labor and delivery for the virus responsible for coronavirus disease 2019. Am J Obstet Gynecol 2020; 223 (02) 284-286
    CrossrefPubMedGoogle Scholar
  • 3 Verdoni L, Mazza A, Gervasoni A. et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet 2020; 395 (10239): 1771-1778
    CrossrefPubMedGoogle Scholar
  • 4 Coronado Munoz A, Nawaratne U, McMann D, Ellsworth M, Meliones J, Boukas K. Late-onset neonatal sepsis in a patient with COVID-19. N Engl J Med 2020; 382 (19) e49
    CrossrefPubMedGoogle Scholar
  • 5 Piersigilli F, Carkeek K, Hocq C. et al. COVID-19 in a 26-week preterm neonate. Lancet Child Adolesc Health 2020; 4 (06) 476-478
    CrossrefPubMedGoogle Scholar
  • 6 Reddy A, Engelhardt K, Jain D. Air leak syndrome in two very preterm infants born to mothers with coronavirus disease 2019: an association or a coincidence?. AJP Rep 2020; 10 (03) e266-e269
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Chandrasekharan P, Vento M, Trevisanuto D. et al. Neonatal resuscitation and postresuscitation care of infants born to mothers with suspected or confirmed SARS-CoV-2 infection. Am J Perinatol 2020; 37 (08) 813-824
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Puopolo K, Hudak M, Kimberlin D, Cummings J. Initial Guidance: Management of Infants Born to Mothers with COVID-19. Accessed May 18, 2020 at: https://downloads.aap.org/AAP/PDF/COVID%2019%20Initial%20Newborn%20Guidance.pdf
    PubMedGoogle Scholar
  • 9 Woloshin S, Patel N, Kesselheim AS. False negative tests for SARS-CoV-2 infection - challenges and implications. N Engl J Med 2020; 383 (06) e38
    CrossrefPubMedGoogle Scholar
  • 10 Wang S, Guo L, Chen L. et al. A case report of neonatal 2019 coronavirus disease in China. Clin Infect Dis 2020; . 28; 71 (15) 853-857
    CrossrefPubMedGoogle Scholar
  • 11 Hu X, Gao J, Luo X. et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vertical transmission in neonates born to mothers with coronavirus disease 2019 (COVID-19) pneumonia. Obstet Gynecol 2020; 136 (01) 65-67
    CrossrefPubMedGoogle Scholar
  • 12 Penfield CA, Brubaker SG, Limaye MA. et al. Detection of severe acute respiratory syndrome coronavirus 2 in placental and fetal membrane samples. Am J Obstet Gynecol MFM 2020; 2 (03) 100133
    CrossrefPubMedGoogle Scholar