Coronavirus Disease-2019 Infection in Neonates of an Infected Pregnant Mother with Triplets

Document Type: Case Report

Authors

1 Department of Neonatology, Tehran University of Medical Sciences, Arash Hospital, Tehran, Iran

2 Department of Intensive Care Medicine, Tehran University of Medical Sciences, Arash Hospital, Tehran, Iran

3 Department of Pediatrics, Tehran University of Medical Sciences, Arash Hospital, Tehran, Iran

4 Newborn Expert in Vise Chancellor for Treatment, Tehran University of Medical Sciences, Tehran, Iran

5 Department of Pediatric Nephrology, Tehran University of Medical Sciences, Arash Hospital, Tehran, Iran

6 Department of Pediatric Pulmonary Diseases, Iran University of Medical Sciences, Firoozabadi Hospital, Tehran, Iran

10.22038/ijn.2020.49218.1856

Abstract

Background: Coronavirus disease 2019 (COVID-19) infection is continuing its spread across the world with nearly 13 million people involvement by 11 July 2020. It mainly causes respiratory infection and affects different people in different ways. The COVID-19 infection involves many pregnant women worldwide, and maternal-fetal transmission of viral diseases is a major concern about this virus. However, its vertical transmission has to be proven in further studies.
Case report: This study presents a COVID-19-infected woman pregnant with triplets that underwent urgent cesarean section in a tertiary center of gynecology and neonatology. Subsequently, neonatal outcomes will be investigated in this study. All neonates were born with low Apgar scores and transferred to the neonatal intensive care unit (NICU) immediately after birth. Polymerase chain reaction (PCR) test of the second male neonate was positive on days 3 and 6; however, he was finally discharged from the hospital in a good condition. It is worth mentioning that the other two newborns died. All three neonates had white lung with an unfavorable response to treatment.
Conclusion: In this case study, we explain and discuss the probable COVID-19 infection in another two offsprings, elaborate on the mother's risk factors predisposing her to get involved with COVID-19 infection, and recommend some suggestions to avoid such complications.

Keywords


1. World Health Organization. Coronavirus disease 2019 (COVID-19). Geneva: World Health Organization; 2020.
2. Jiang F, Deng L, Zhang L, Cai Y, Cheung CW, Xia Z. Review of the clinical characteristics of coronavirus disease 2019 (COVID-19). J Gen Intern Med. 2020; 35(5):1545-9.
3. Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr. 2020; 9(1):51-60.
4. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020; 395(10226):809-15.
5. Schwartz DA. An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Arch Pathol Lab Med. 2020; 144(7):799-805.
6. Second edition of Iranian National Covid-19 diagnosis and treatment. Iranian Ministry of Health Care and Medical Education. Available at: URL: http://treatment.sbmu.ac.ir/uploads/2-3-covid-19_bastari.pdf; 2020.
7. Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, et al. Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology. 2020; 296(2):E115-7.
8. Novel coronavirus 2019 (COVID-19). The American College of Obstetricians and Gynecologists (ACOG) practice advisory. Available at: URL: https:// www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/03/novel-coronavirus-2019; 2020.