新生儿重型新型冠状病毒肺炎一例

Severe COVID-19 in a newborn

本文报道一例重型新冠状病毒肺炎(COVID-19)新生儿救治过程。患儿男,22 d,2020年2月22日因"间断发热18 d"由外院转入郑州大学附属儿童医院。患儿父母一直武汉居住,分娩前9 d从武汉回到信阳,因母亲疑似COVID-19于孕38周行剖宫产分娩,产后2 d确诊COVID-19。新生儿生后5 d内其父亲和外祖父、外祖母相继确诊。患儿生后5 d出现发热,伴呛咳;生后6 d咽拭子新型冠状病毒核酸检测阳性,在外院治疗18 d后仍间断发热,鼻导管吸氧,停氧后经皮氧饱和度降至79%,为进一步治疗转入本院。入院后仍有咳嗽,偶有呛咳,鼻导管吸氧下呼吸稍促,心率快,尿量偏少,肝右肋下触及2 cm。入院后,患儿诊断为重型COVID-19,伴有高钾血症,胸部CT示肺部炎症,心脏彩超示房间隔缺损,血常规示贫血,给予隔离病房、暖箱内隔离,以及吸氧、强心、输血及抗病毒等治疗后,患儿反应好,吃奶好,无发热,无呼吸道症状,肺部炎症明显吸收,连续2次咽拭子病毒核酸检测阴性,符合出院标准,住院14 d后治愈出院。

We present a case of severe COVID-19 in a male newborn.A 22-day infant was transferred to Children's Hospital Affiliated to Zhengzhou University due to"intermittent fever for 18 days".The parents of the infant had been living in Wuhan and returned to Xinyang 9 days before delivery.Suspecting COVID-19 infection,a cesarean section was performed at 38 gestational weeks.The diagnosis of COVID-19 in the mother was confirmed at 2 days postpartum,as well as the father and the grandparents-in-law within 5 days postpartum.The baby developed fever and cough 5 days after birth,and a positive result for the new coronavirus nucleic acid test in the pharyngeal swab was shown 6 days after birth.The fever continued intermittently for 18 days,whilst nasal catheter oxygen inhalation treatment was administered.The percutaneous oxygen saturation decreased to 79%after cessation of oxygen,and the baby was transferred to the hospital for further treatment.After admission,the infant presented with cough,occasional choke,shortness of breath despite nasal catheter oxygen inhalation,increased heart rate,low urine volume,and an enlarged liver 2 cm below the right costal margin.The baby was diagnosed with severe COVID-19 accompanied by anemia,hyperkalemia,pneumonia,and atrial septal defect seen on the echocardiogram.After isolation in an incubator,oxygen inhalation,cardiotonic intervention,blood transfusion and antiviral treatment,the patient made a good recovery,with good breastfeeding,significant resorption of the lung inflammation and no fever or respiratory symptoms.The baby was discharged 14 days after hospitalization,with negative results for nucleic acid test of pharyngeal swab for 2 consecutive times.