Late-neonatal SARS-CoV-2 infection: A curious case of COVID‑19 with respiratory co-infection and treatment with surfactant

At the height of the COVID‑19 pandemic, South Africa became the epicentre of the continent. Considering the paucity of data onCOVID‑19, we aimed to describe the clinical picture in a neonate, alert healthcare workers to the presence of co-infection with COVID‑19 and propose alternative treatment modalities. The use of surfactant was based on the pathophysiological mechanisms of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). There is mounting evidence in support of using surfactant in the management of severe COVID‑19. While viral co-infection is a common occurrence among neonates, our case shows that COVID‑19, together with rhinovirus infection, may result in a more rapid clinical deterioration, as opposed to rhinovirus infection in isolation.