INTRODUCTION:
In December of 2019, a new strain of Corona virus emerged in Wuhan,
China which resulted in the COVID-19 pandemic1. Among
the children infected by the virus, most are asymptomatic and only few,
especially infants and those with co-morbid conditions, have severe
disease2. However, MIS-C, is a more severe form of
disease occurring 4-5 weeks after the infection, and capable of causing
multiorgan failure3. The hyperinflammatory state of
MIS-C predisposes to a prothrombotic coagulopathy known as
thrombo-inflammation making patients prone to thromboembolic
complications including Pulmonary thromboembolism
(PTE)4. Winant et al3 observed
segmental pulmonary emboli in patients of MIS-C on thoracic imaging and
recommended to have high suspicion of embolism in these patients. There
are now emerging reports of Neonatal MIS-C (MIS-N), mainly presenting
with cardiac manifestations, ground glass opacities in the lungs and
elevated inflammatory markers 5,6,7,8,9. PTE is not
common among the neonatal population and is a consequence of imbalance
between procoagulant and anticoagulant systems10.
Indwelling central lines, fluid instabilities, sepsis, liver
dysfunction, congenital heart disease, occult malignancy, and systemic
inflammation contribute to the risk profile for thromboembolism in
critical neonates10,11.
Here we report a rare case of a neonate born to a mother with COVID 19
infection during pregnancy, who presented to us with respiratory
distress, raised inflammatory markers and having cavitary and nodular
lesions in the lung, which we suspect could have resulted from
thromboembolic complication of MIS-N.