Case report: Fatal lung hyperinflammation in a preterm newborn with SARS-CoV-2 infection.

Case report: Fatal lung hyperinflammation in a preterm newborn with SARS-CoV-2 infection.
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DOI:
10.3389/fped.2023.1144230
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发表时间:
2023
影响因子:
2.6
通讯作者:
--
中科院分区:
医学3区
文献类型:
--
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SARS-CoV-2从母亲到胎儿的垂直传播被广泛接受。尽管大多数感染的新生儿表现为轻度症状或无症状,但呼吸窘迫综合征(RDS)和肺部异常影像在COVID-19阳性新生儿中的发生率明显高于非感染新生儿。死亡是罕见的,病例报告和系列的不一致荟萃分析将围产期母亲COVID-19状态与新生儿疾病严重程度相关,使其外推为预后指标变得复杂。需要建立一个更大的数据库,收集更极端病例的详细病例报告,以制定治疗指南,并做出知情决策。在这里,我们报告了一个不寻常的情况下,28周的妊娠婴儿与围产期获得性SARS-CoV-2,谁开发严重的持久性呼吸衰竭。尽管从出生开始就接受了一线抗病毒和抗炎治疗的重症监护,但呼吸衰竭持续存在,并在5个月时死亡。肺组织病理学显示重度弥漫性支气管肺炎,心脏和肺免疫组织化学证实巨噬细胞浸润、血小板活化和中性粒细胞胞外陷阱形成与晚期多系统炎症一致。据我们所知,这是第一个报告的SARS冠状病毒-2肺过度炎症的早产儿与致命的结果。
Vertical transmission of SARS-CoV-2 from mother to fetus is widely accepted. Whereas most infected neonates present with mild symptoms or are asymptomatic, respiratory distress syndrome (RDS) and abnormal lung images are significantly more frequent in COVID-19 positive neonates than in non-infected newborns. Fatality is rare and discordant meta-analyses of case reports and series relating perinatal maternal COVID-19 status to neonatal disease severity complicate their extrapolation as prognostic indicators. A larger database of detailed case reports from more extreme cases will be required to establish therapeutic guidelines and allow informed decision making. Here we report an unusual case of a 28 weeks' gestation infant with perinatally acquired SARS-CoV-2, who developed severe protracted respiratory failure. Despite intensive care from birth with first line anti-viral and anti-inflammatory therapy, respiratory failure persisted, and death ensued at 5 months. Lung histopathology showed severe diffuse bronchopneumonia, and heart and lung immunohistochemistry confirmed macrophage infiltration, platelet activation and neutrophil extracellular trap formation consistent with late multisystem inflammation. To our knowledge, this is the first report of SARS CoV-2 pulmonary hyperinflammation in a preterm newborn with fatal outcome.
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影响因子: --
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发表时间: 2021
期刊: PloS one
影响因子: 3.7
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