Fatal cerebral infarct in a child with COVID-19
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LETTER TO THE EDITOR
Fatal cerebral infarct in a child with COVID-19 Shingo Kihira 1
&
Peter F. Morgenstern 2 & Hillary Raynes 3 & Thomas P. Naidich 1 & Puneet Belani 1
Received: 1 June 2020 / Revised: 17 June 2020 / Accepted: 8 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Dear Editors, Severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) causes a cytokine storm through angiotensinconverting enzyme 2 (ACE2) receptor binding, leading to a hypercoagulable state [1, 2]. This has led to increased incidence of vascular thromboses in people with coronavirus disease 2019 (COVID-19) [3, 4]. It has been reported that children with SARS-CoV-2 infrequently have severe disease [5]. At our institution in New York City, we saw only four cases of children presenting with SARS-CoV-2 infection and demonstrating Kawasaki-like symptomatology between March 15 and April 30 of 2020. Here we write about an unusual case to raise awareness that a post-infectious syndrome associated with SARS-CoV-2 can be fatal in children. A 5-year-old boy with no significant medical history presented with 3 days of fever, cough and abdominal pain. He was diagnosed with prior COVID-19 infection through plasma antibody assay. D-dimer at presentation was elevated (12 μg/mL; normal range
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