Vertical Transmission of COVID-19 Infection in a Newborn

Abstract

Coronavirus Disease-2019 (COVID-19), in its second wave, is infecting the young children and newborns too. Increasing number of pregnant women with COVID-19 is being reported globally, and the potential for vertical transmission of Severe Acute Respiratory Syndrome- Coronavirus-2 (SARS-CoV-2), either in-utero, intrapartum or in the early postnatal period is of concern. At present, the extent to which SARS-CoV-2 vertical transmission occurs, and timing of such transmission is unclear. This report describes the clinical course and laboratory findings in a neonate in whom SARS-CoV2 infection most likely occurred via vertical transmission. As the baby developed audible grunting and tachypnoea, 10 minutes after birth, all the relevant laboratory investigations were done. The chest X-ray showed bilateral lung opacities. The neonate developed signs and symptoms of severe COVID-19 pneumonia on day 1 of life, completely manifesting within few hours of birth. The nasopharyngeal swab was sent for Reverse Transcriptase- Polymerase Chain Reaction (RT-PCR) for SARS-CoV 2 after two days of birth. The RT-PCR test came out positive. With all other causes been ruled out and contributory laboratory findings (raised D-Dimer, lactate dehydrogenase and erythrocyte sedimentation rate) it can positively be labelled as a case of vertically transmitted intrauterine COVID-19 pneumonia in a newborn. The baby was treated with ventilator support, antibiotics and Low Molecular Weight Heparin (LMWH), and finally discharged after nine days of life and management at the hospital.