Download PDF
J Pediatr Infect Dis 2022; 17(05): 221-226
DOI: 10.1055/s-0042-1755209
Original Article

Increased Rate of Spontaneous Pneumothorax in Infants of COVID-19 Positive Mothers

Selçuk Gürel
1   Department of Pediatrics, Uşak Öztan Hospital, Uşak, Turkey
,
Şule Yıldırım
1   Department of Pediatrics, Uşak Öztan Hospital, Uşak, Turkey
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Objective The epidemiological and clinical characteristics of neonates born to women infected with coronavirus disease 2019 (COVID-19) during pregnancy were assessed, and the correlation between this infection and spontaneous pneumothorax in neonates born to mothers with COVID-19 was evaluated in the present study.

Methods Records of 14 neonates in the neonatal intensive care unit with pneumothorax were collected and analyzed. Pregnant women were routinely screened for COVID-19 before birth. This study only included the neonates of mothers positive for severe acute respiratory syndrome coronavirus 2 immunoglobulin Mand immunoglobulin G and developing spontaneous pneumothorax. Antenatal, natal and postnatal risk factors, data related to demographic, epidemiological and clinical characteristics, treatment strategies, and breastfeeding history were obtained from medical records.

Results The gestational age of the 14 neonates was 30 to 38 weeks. One male infant was born by normal spontaneous vaginal delivery, while all other infants were born by C-section. Though the mothers did not have a diagnosis of COVID-19 in their charts, they all reported one or more symptoms when interviewed. No mother had received a COVID-19 vaccination before or during pregnancy. No mother had undergone a hospital visit or doctor examination due to suspicion of COVID and COVID polymerase chain reaction test. COVID antibody titers were present during admission to hospital before birth.

Conclusion The infants of pregnant cases with symptomatic or asymptomatic COVID-19 may develop respiratory distress and pneumothorax. Observational data obtained from case series similar to what is presented here may be accepted as a potential first step to producing hypotheses to test with preclinical or clinical models if it can be expanded in larger cohorts.

Keywords

pneumothorax - newborn - COVID-19 - pregnancy - surfactant


Publication History

Received: 07 March 2022

Accepted: 06 June 2022

Article published online:
14 September 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Oncel MY, Akın IM, Kanburoglu MK. et al; Neo-Covid Study Group. A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society. Eur J Pediatr 2021; 180 (03) 733-742
    CrossrefPubMedGoogle Scholar
  • 2 WHO. Coronavirus Disease (COVID-19) Dashboard. Accessed July 24, 2021 at: https:// covid19.who.int/
    PubMedGoogle Scholar
  • 3 Gurel S. Current state of COVID-19 in the pediatric population. J Paediatr Neonatal Med 2020; 2 (02) 117
    PubMedGoogle Scholar
  • 4 Yang H, Sun G, Tang F. et al. Clinical features and outcomes of pregnant women suspected of coronavirus disease 2019. J Infect 2020; 81 (01) e40-e44
    CrossrefPubMedGoogle Scholar
  • 5 Capobianco G, Saderi L, Aliberti S. et al. COVID-19 in pregnant women: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2020; 252: 543-558
    CrossrefPubMedGoogle Scholar
  • 6 Patanè L, Morotti D, Giunta MR. et al. Vertical transmission of coronavirus disease 2019: severe acute respiratory syndrome coronavirus 2 RNA on the fetal side of the placenta in pregnancies with coronavirus disease 2019-positive mothers and neonates at birth. Am J Obstet Gynecol MFM 2020; 2 (03) 100145
    CrossrefPubMedGoogle Scholar
  • 7 Hecht JL, Quade B, Deshpande V. et al. SARS-CoV-2 can infect the placenta and is not associated with specific placental histopathology: a series of 19 placentas from COVID-19-positive mothers. Mod Pathol 2020; 33 (11) 2092-2103
    CrossrefPubMedGoogle Scholar
  • 8 Penfield CA, Lighter J, Roman AS. Intrauterine vertical transmissibility of SARS-CoV-2: the evidence is evolving. Am J Obstet Gynecol MFM 2020; 2 (04) 100227-100227
    CrossrefPubMedGoogle Scholar
  • 9 Vivanti AJ, Vauloup-Fellous C, Prevot S. et al. Transplacental transmission of SARS-CoV-2 infection. Nat Commun 2020; 11 (01) 3572
    CrossrefPubMedGoogle Scholar
  • 10 Kirtsman M, Diambomba Y, Poutanen SM. et al. Probable congenital SARS-CoV-2 infection in a neonate born to a woman with active SARS-CoV-2 infection. CMAJ 2020; 192 (24) E647-E650
    CrossrefPubMedGoogle Scholar
  • 11 Abushahin A, Degliuomini J, Aronow WS, Newman T. A case of spontaneous pneumothorax 21 days after diagnosis of coronavirus disease 2019 (COVID-19) pneumonia. Am J Case Rep 2020; 21: e925787
    CrossrefPubMedGoogle Scholar
  • 12 Alhakeem A, Khan MM, Al Soub H, Yousaf Z. Case report: COVID-19-associated bilateral spontaneous pneumothorax-a literature review. Am J Trop Med Hyg 2020; 103 (03) 1162-1165
    CrossrefPubMedGoogle Scholar
  • 13 Eperjesiova B, Hart E, Shokr M, Sinha P, Ferguson GT. Spontaneous pneumomediastinum/pneumothorax in patients with COVID-19. Cureus 2020; 12 (07) e8996
    PubMedGoogle Scholar
  • 14 do Lago VC, Cezare TJ, Fortaleza CMCB, Okoshi MP, Baldi BG, Tanni SE. Does COVID-19 increase the risk for spontaneous pneumothorax?. Am J Med Sci 2020; 360 (06) 735-737
    CrossrefPubMedGoogle Scholar
  • 15 Noppen M. Spontaneous pneumothorax: epidemiology, pathophysiology and cause. Eur Respir Rev 2010; 19 (117): 217-219
    CrossrefPubMedGoogle Scholar
  • 16 Çördük N, Ürey T, Küçüktaşçı K. et al. Evaluation of newborns with pneumothorax. Pam Tıp Derg 2014; 7 (01) 47-51
    CrossrefPubMedGoogle Scholar
  • 17 Al Tawil K, Abu-Ekteish FM, Tamimi O, Al Hathal MM, Al Hathlol K, Abu Laimun B. Symptomatic spontaneous pneumothorax in term newborn infants. Pediatr Pulmonol 2004; 37 (05) 443-446
    CrossrefPubMedGoogle Scholar
  • 18 Alzamora MC, Paredes T, Caceres D, Webb CM, Valdez LM, La Rosa M. Severe COVID-19 during pregnancy and possible vertical transmission. Am J Perinatol 2020; 37 (08) 861-865
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Moeindarbary S, Pourhoseini A, Layegh P. et al. Neonates with coronavirus disease 2019 acquired from infected mothers: the incompatibility of maternal intensity and infant lung involvement: two case reports. J Med Case Reports 2021; 15 (01) 310
    CrossrefPubMedGoogle Scholar
  • 20 De Luca D. Managing neonates with respiratory failure due to SARS-CoV-2. Lancet Child Adolesc Health 2020; 4 (04) e8
    CrossrefPubMedGoogle Scholar
  • 21 Schramel F, Meyer CJ, Postmus PE. Inflammation as a cause of spontaneous pneumothorax and emphysema-like changes: results of bronchoalveolar lavage. Eur Respir Rev 1995; 8 (Suppl. 19): 397s
    PubMedGoogle Scholar
  • 22 Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood 2020; 135 (23) 2033-2040
    CrossrefPubMedGoogle Scholar
  • 23 Liu K, Zeng Y, Xie P. et al. COVID-19 with cystic features on computed tomography: A case report. Medicine (Baltimore) 2020; 99 (18) e20175
    CrossrefPubMedGoogle Scholar
  • 24 Lu-Culligan A, Chavan AR, Vijayakumar P. et al. SARS-CoV-2 infection in pregnancy is associated with robust inflammatory response at the maternal-fetal interface. medRxiv 2021; 2 (05) 591-610
    PubMedGoogle Scholar
  • 25 Dong Y, Mo X, Hu Y. et al. Epidemiology of COVID-19 among children in China. Pediatrics 2020; 145 (06) e20200702
    CrossrefPubMedGoogle Scholar
  • 26 Celik O, Saglam A, Baysal B. et al. Factors preventing materno-fetal transmission of SARS-CoV-2. Placenta 2020; 97: 1-5
    CrossrefPubMedGoogle Scholar
  • 27 Zeng H, Xu C, Fan J. et al. Antibodies in infants born to mothers with COVID-19 pneumonia. JAMA 2020; 323 (18) 1848-1849
    PubMedGoogle Scholar
  • 28 Zhou J, Wang Y, Zhao J. et al. The metabolic and immunological characteristics of pregnant women with COVID-19 and their neonates. Eur J Clin Microbiol Infect Dis 2021; 40 (03) 565-574
    CrossrefPubMedGoogle Scholar
  • 29 Hsu AL, Guan M, Johannesen E. et al. Placental SARS-CoV-2 in a pregnant woman with mild COVID-19 disease. J Med Virol 2021; 93 (02) 1038-1044
    CrossrefPubMedGoogle Scholar
  • 30 Schoenmakers S, Snijder P, Verdijk RM. et al. Severe acute respiratory syndrome coronavirus 2 placental infection and inflammation leading to fetal distress and neonatal multi-organ failure in an asymptomatic woman. J Pediatric Infect Dis Soc 2021; 10 (05) 556-561
    CrossrefPubMedGoogle Scholar
  • 31 Kamity R, Nayak A, Dumpa V. Pneumothorax in neonates born to COVID-19-positive mothers: fact or fortuity?. AJP Rep 2021; 11 (01) e49-e53
    Article in Thieme ConnectPubMedGoogle Scholar
  • 32 Mendoza-Hernández M, Huerta-Niño de Rivera I, Yoldi-Negrete M. et al. Probable case of vertical transmission of SARS-CoV-2 in a newborn in Mexico. Neonatology 2021; 118 (03) 364-367
    CrossrefPubMedGoogle Scholar
  • 33 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
  • 34 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