Chinese Journal of Evidence -Based Pediatric ›› 2020, Vol. 15 ›› Issue (1): 37-41.

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Transport, diagnosis and treatment of a newborn with severe SARS-CoV-2 infection: A case report

 YU Zeng-yuan1,3, XUE Wei2,3, FENG Ying-jun1, BAI Qiong-dan1, JIANG Ming-li1, WANG Jing1, LI Peng1, YANG Hui-yan1, KANG Wen-qing1   

  1.  1 Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450018, China; 2 Xinyang Central Hospital, Xinyang 464099, China; 3 Co-first author
  • Received:2020-03-13 Revised:2020-03-27 Online:2020-02-25 Published:2020-03-16
  • Contact: KANG Wen-qing
  • Supported by:
     

Abstract: ObjectiveTo explore the diagnosis and treatment of neonatal SARS-CoV-2 infection, the transmission ability of SARS-CoV-2, and the safety of transport. MethodsThe epidemiological history, transport process, treatment methods and the outcome of a neonate with SARS-CoV-2 infection were analyzed. ResultsThe newborn, male, 22 days old, was transported to the Children's Hospital Affiliated of Zhengzhou University on February 22, 2020 due to the intermittent fever for 17 days by a negative-pressure ambulance from Xinyang Central Hospital. On January 22, his father and mother (37+3 weeks pregnant) returned to the home of his maternal grandparents in Henan Province from Wuhan, Hubei Province to prepare for the birth and later the mother, father and maternal grandparents had fever and other symptoms one after another. After the cesarean section on January 31, the mother and newborn lived in the same ward. On February 1, the mother was diagnosed with COVID-19 and his father and maternal grandparents were diagnosed with COVID-19 successively. On February 5, the newborn had fever and was diagnosed with COVID-19 the next day with chest X-ray showing diffuse consolidation. After 17-day isolation treatment in Xinyang Central Hospital, his temperature was 37.5 ℃ and a nasal cannula was still needed for inhaling oxygen. Healthcare providers under the tertiary personal protection spent 4.5 hours transporting him to our hospital by a negative-pressure ambulance. In our hospital, he was put in an incubator and given artificial feeding and a nasal cannula with FiO2 40% and a flow rate of 1 L·min-1 and interferon α-1b was sprayed into the nasal cavity. Bedside cardiac color Doppler ultrasound showed an atrial septal defect (6.9 mm), 1 950 pg·mL-1 for NT-proB-type Natriuretic Peptide (BNP) blood test and manifestations of cardiac insufficiency, and a balanced fluid intake was given. On February 28, the newborn's nasopharyngeal swabs were tested negative for SARS-CoV-2. On March 1, his nasopharyngeal swabs and stools were tested negative and the chest CT showed most shadow at the lower right lung disappeared. On March 6, the newborn was discharged. ConclusionA long-distance transport of a severe neonatal COVID-19 case was possible under effective safety protection measures when there was a need. This case did not support vertical transmission from mother to neonates and there were no adults infected by the newborn. Fluid management should be paid more attention when heart disease is combined.

 

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