Postnatally-Acquired COVID-19 in Central India
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Postnatally-Acquired COVID-19 in Central India
RT-PCR for SARS-COV-2 were negative for each mother twice. The babies were discharged home without supplemental oxygen after two repeat samples were negative. The cases are presented to highlight the importance of mutual transmission of disease between mother, infant and other caregivers in the family. Infection was suspected in both infants based on clinical presentation and family history of infection in one or more family members. Recent research has shown that apart from droplets, infection can be transmitted through saliva of the infant [2] during breastfeeding, and stool of the infant [3-5], as viral shedding continues for several weeks in neonates. However, breastfeeding needs to be continued as per current recommendations [6], with regular hand washing with soap and water and proper diaper disposal. The presented cases signify the importance of proper hygiene in preventing transmission of infection from infected infants to nursing mothers, caregivers and vice versa.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infections have achieved pandemic proportions; although, pediatric manifestations still remain poorly delineated [1]. We describe two infants with postnatally acquired SARS-CoV-19 infection and discuss pertinent issues. A 21-day-old girl was admitted with history of tachypnea for 1 day. She was born at 39 weeks of gestation with a birth weight of 3000 g to a primigravida mother who had an uneventful antenatal history. On admission, the temperature was 36.5°C, with pulse 140 beats per minute and respiratory rate 60 breaths per minute (oxygen saturation 90% in room air). Chest radiograph showed bilateral diffuse infiltrates. Laboratory investigations revealed hemoglobin of 11.1 g/dL, total leukocyte count 15,700/cumm (polymorphs 26%, lymphocytes 55%), platelets 6.69 ×109/L, alanine transaminase 28 IU/L, serum ferritin 178 ng/mL, lactate dehydrogenase (LDH) 320 U/L and C-reactive protein (CRP) 0.5 mg/dL. Her nasal swab Reverse transcriptase polymerase chain reaction (RT-PCR) was positive for SARS-CoV-2. On contact tracing, the father and paternal grandfather were reported to be positive for SARS-CoV-2.
Published online: July 07, 2020; PII: S097475591600206 JENISHA JAIN* AND SHIKHAR JAIN Department of Pediatrics Choithram Hospital and Research Centre, Indore, Madhya Pradesh, India. *[email protected] REFERENCES 1. Balasubramanian S, Rao NM, Goenka A, Roderick M, Ramanan AV. Coronavirus disease 2019 (COVID-19) in children - What we know so far and what we do not. Indian Pediatr. 2020;57:435-42. 2. Xu R, Cui B, Duan X, Zhang P, Zhou X, Yuan Q. Saliva: Potential diagnostic value and transmission of 2019nCoV. Int J Oral Sci. 2020;12:11. 3. Xing YH, Ni W, Wu Q, Li WJ, Li GJ, Wang WD, et al. Prolonged viral shedding in feces of pediatric patients with coronavirus disease 2019. J Microbiol Immunol Infect. 2020;53:473-80. 4. Ma X, Su L, Zhang Y, Zhang X, Gai Z, Zhang Z. Do children need a longer time to shed SARS-CoV-2 in stool than adults? J Micr
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