Death of a 3 Month-Old Infected Infant with Dilated Cardiomyopathy after COVID-19 Infection: A Case Report

Background: Several numbers of studies have reported that coronavirus disease-2019 (COVID-19) in infants and children have shown milder symptoms and a better prognosis than in adult patients. However, there is no sufficient evidence on the effect of cardiovascular involvement in COVID-19 in the infant. Case Report: Here, we report an infant infected with COVID-19 with the manifestations of dilated myocarditis. The patient was referred to Pediatric Emergency with lethargy and tachypnea. On physical examination, she had holosystolic murmur with grade 3/6. The laboratory examinations showed anemia as well as increased alkaline phosphatase (ALP) levels. Due to respiratory distress, she was intubated and put under mechanical ventilation. The diagnosis of COVID-19 infection was confirmed by real-time polymerase chain reaction (RT-PCR) using a pharyngeal specimen. Finally, dilated cardiomyopathy (DCM) was diagnosed and one day after hospitalization the infant was died due to complications of DCM. Conclusion: It seems that in the infant with severe underlying disease, even a mild COVID-19 infection, may be lethal. Focal viral myocarditis is a very rare condition described by localized disturbance of the myocardium occurring in ventricular dysfunction with significant morbidity and mortality. Thus, due to the possibility of cardiac injury in infected neonates with COVID-19 disease and the manifestation of myocarditis, effective measurement is recommended.