Coronavirus disease 2019 (COVID-19), a condition associated with SARS-CoV-2, typically results in mild infection in infants and children. However, children with risk factors such as chronic lung disease and immunosuppression have higher risk of severe illness from COVID-19. We report a case of a 27-week-gestation extremely premature infant born to a mother with COVID-19 infection. The infant, initially treated for surfactant deficiency, developed worsening hypoxic respiratory failure on the fifth day of life requiring escalating ventilatory support, an elevated level of C-reactive protein, thrombocytopenia, and an elevated level of d-dimer. The infant was positive for SARS-CoV-2 by RT-PCR from Day 1 to Day 42 of his life. The infant responded to a seven-day course of dexamethasone with a gradually decreasing oxygen requirement and could be extubated to non-invasive ventilation by the end of the fifth week after birth. The infant is currently on home oxygen by nasal cannula. Prolonged shedding of the virus may be a unique feature of the disease in premature infants. Extreme prematurity, immature lungs, and an immunocompromised status may predispose these infants to severe respiratory failure and a prolonged clinical course. Instituting appropriate COVID-19 protocols to prevent the spread of the disease in the neonatal intensive care unit (NICU) is of utmost importance. Infection with SARS-CoV-2 may have implications in the management of extremely premature infants in the NICU.
【저자키워드】 COVID-19, SARS-CoV-2, Respiratory failure, Infant, Prematurity, 【초록키워드】 Dexamethasone, Coronavirus disease 2019, protocol, intensive care, hypoxic respiratory failure, children, severe respiratory failure, Infection, Immunosuppression, Lung disease, C-reactive protein, oxygen, nasal, risk factor, RT-PCR, virus, Spread, Infants, Clinical course, management, Lungs, non-invasive ventilation, Premature, mild infection, mother, Prolonged, Neonatal, ventilatory support, deficiency, NICU, higher risk, worsening, positive, Oxygen requirement, implication, Prevent, immunocompromised status, Course, the disease, Day, elevated, treated, unique, immature, with COVID-19, 【제목키워드】 Neonate, respiratory, failure, with COVID-19,