COVID-19 infected neonate presenting with cytokine storm and sepsis

Abstract

COVID-19, a clinical syndrome caused by the coronavirus (SARS-CoV-2) became a pandemic following an outbreak of viral pneumonitis, first identified in Wuhan, China. The disease manifestations vary ranging from mild upper respiratory tract infection to severe pneumonitis, acute respiratory distress syndrome (ARDS) and even death. Although most of the neonatal cases are asymptomatic, rarely, they can present with cytokine storm mimicking with similar features of sepsis. This is a case report of SARS-CoV19 positive neonate presenting with sepsis and cytokine storm, 5-day old baby born to SARS-COVID 19 positive mother presented with fever and investigations showed elevated total counts with neutrophilic predominance, thrombocytopenia suggestive of sepsis and increased inflammatory markers suggestive of cytokine storm. Blood culture was sent and baby was started on intravenous antibiotics. In view of cytokine storm intravenous dexamethasone 0.5 mg/kg/day was given intravenously for 5 days. Neonate recovered from illness after 1 week as evidenced clinically and and by the fall in inflammatory markers before discharge. This report opens the possibility of having both sepsis and cytokine storm in a SARS-CoV19 positive neonate.