新生儿临床早发脓毒症和COVID-19:一例报告

M. Saeedi, Razieh Sangsari, K. Mirnia
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摘要

导言:2020年2月19日,伊朗卫生部正式宣布COVID-19大范围传播后,我们的注意力集中在新型冠状病毒上。在我们的病例中,2天大的新生儿表现出败血症的症状。主要表现为体温过低和去饱和。母亲呈COVID-19阳性,咳嗽活跃。新生儿PCR结果为阴性。我们并不是说新生儿受到了COVID-19的影响,但这可能是COVID-19阳性母亲的新生儿的非典型败血症。病例介绍:产妇为34岁初产妇,妊娠期无任何疾病史,经剖宫产产下一名2天大、胎龄40周、出生体重2370克的女婴。临产前两天,产妇身体不适,并伴有干咳。她在分娩后通过RT-PCR被诊断为新冠病毒阳性。出生后第二天,父母带着婴儿来到儿童医疗中心医院急诊室,主诉喂养不良、吸吮不良、排尿减少。体格检查发现以下征象:体温过低;T=36℃,原始反射减弱,低张力,氧饱和度下降至85%,无呼吸窘迫,呼吸窘迫增加至98%。我们收治并治疗了她的早发败血症,出院时情况良好。结论:早发性脓毒症是一种由母体转移而来的临床状态。在我们的病例中,表现可能是一种新的临床败血症,在一位患有COVID-19的母亲之后。我们并不是说我们的病例是COVID-19阳性,但应该关注患有受感染母亲潜伏症状的新生儿。
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Neonatal Clinical Early-onset Sepsis and COVID-19: A Case Presentation
Introduction: After the Ministry of the health of Iran officially announced widespread of COVID-19 on 19 February 2020, our attention focused on novel coronavirus. In our case, a2-day- old neonate shows symptoms of sepsis. The main presentation was hypothermia and desaturation. The mother was COVID-19 positive with an active cough. The PCR of the neonate was negative. We don’t claim that the neonate is affected by COVID-19, but this may be an atypical form of sepsis in neonates with positive mothers following COVID-19.  Case presentation: A2-day- old female neonate with a gestational age of 40 weeks and a birth weight of 2370 grams was born via the cesarean route from a mother who was a 34-year-old primigravida woman without any history of disease during pregnancy. Two days before delivery, the mother had malaise and dry cough. She was diagnosed as a COVID-19 positive case based on RT-PCR after delivery. On the second day after birth, the parents brought the baby to the emergency room of the children’s medical center hospital with complaints of poor feeding, poor sucking and decreased urination. Physical examination revealed the following signs; hypothermia; T=36℃, diminished primitive reflexes, hypotonia, and oxygen desaturation until 85% without respiratory distress that increased to 98% with oxy hood. We admitted and treated her early-onset sepsis and discharged in excellent condition. Conclusion: Early-onset sepsis as defined is a clinical state that is transferred from mother. The presentations in our case maybe a new form of clinical sepsis following a mother with COVID-19. We don’t claim that our case is COVID-19 positive but in neonates with affected mother’s insidious symptoms should be in concern.
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