A newborn was recently treated for COVID-19 he contracted in utero. The boy was delivered on May 24 through Cesarean section and was brought to Dr. Mehta’s Hospital in Velapanchavadi within two hours of birth with respiratory distress.
An RT-PCR test confirmed the infection. The mother was infected but was asymptomatic and had later tested negative. Doctors diagnosed it as a rare case of transplacental infection with fetal hyper-inflammatory syndrome.
A CT scan for the chest revealed that the baby, born at 37 weeks of gestation, had 80-90% lung involvement. The mother had an uneventful antenatal period but had gestational diabetes and pregnancy-induced hypertension.
Consultant neonatologist Arun Krishnan B. said the neonate was started on non-invasive positive pressure ventilation and received two doses of surfactant at two hours and eight hours of life. The baby was on mechanical ventilation for five days and then for three days in a high-flow nasal cannula. The baby was under observation for three days. He had a few episodes of intermittent tachycardia, which was evaluated and concluded as inappropriate sinus tachycardia post-COVID-19 hyper-inflammatory syndrome.
The baby recovered and was discharged after 11 days of hospitalisation with oral steroids and blood thinners.
“Even though the mother had tested negative, her antibody levels were elevated indicating transplacental transmission of antibodies from mother to baby. The baby’s blood showed high levels of antibodies, but they were of the IGM variety, which do not cross the placenta. This led to the conclusion that the baby was infected transplacentally, and produced an immune response which triggered the hyper inflammatory syndrome,” Dr. Arun explained.
In neonates the infection is mostly asymptomatic or mild, and across the globe, less than five cases of fetal hyper-inflammatory syndrome had been reported, he added. The hospital had treated a few neonates who had been infected transplacentally in the first wave but were asymptomatic or had mild and self-limiting infections.
Group medical director N. Kannan said the hospital had treated over 3,300 COVID-19 patients, including over 370 sick patients in the intensive care unit.
