Early Outcome of Multisystem Inflammatory Syndrome in Neonates Diagnosed following Prenatal Maternal COVID-19 Infection: A Three-Case Series
Background: The aim of this case series report is to evaluate the characteristics of multisystem inflammatory syndrome (MIS) in neonates following prenatal maternal COVID-19 infection. Methods: We present a case series of three newborns (≤28 days of age) diagnosed with MIS due to the vertical transm...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-10-01
|
| Series: | Pediatric Reports |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2036-7503/15/4/54 |
| _version_ | 1827573878600237056 |
|---|---|
| author | Maria Terciu Ioana Luca Emilia Panait Eugene Leibovitz Maria Mitrica Bianca Popovici Anca Ilea Oana Gabriela Falup-Pecurariu |
| author_facet | Maria Terciu Ioana Luca Emilia Panait Eugene Leibovitz Maria Mitrica Bianca Popovici Anca Ilea Oana Gabriela Falup-Pecurariu |
| author_sort | Maria Terciu |
| collection | DOAJ |
| description | Background: The aim of this case series report is to evaluate the characteristics of multisystem inflammatory syndrome (MIS) in neonates following prenatal maternal COVID-19 infection. Methods: We present a case series of three newborns (≤28 days of age) diagnosed with MIS due to the vertical transmission of SARS-CoV2 infection and admitted from 1 January 2021 to 1 June 2023. The inclusion criteria were negative RT-PCR-SARS-CoV-2 test in infants, initial negative IgM-SARS-CoV-2 in infants followed by the emergence of positive IgG-SARS-CoV-2 antibodies in infants and maternal COVID-19 infection in the third trimester of pregnancy. Patients enrolled in this case series were admitted due to acute febrile illnesses. Results: All three cases occurred in patients born at a mean gestational age of 39 weeks and who were appropriate for gestational age. The mean age at admission was 18.3 days. Fibrinogen (>400 mg/dL) and ferritin (>120 mg/dL) were elevated above the upper normal limit. Elevated levels of myocardial biomarkers (D-dimers, N-terminal pro b-type natriuretic peptide troponin T and creatine phosphokinase myocardial band) were recorded, with normal heart function evaluated using echocardiography. All three patients were treated with antibiotics; one received intravenous immunoglobulin. A 4-week follow-up was completed in two patients when their myocardial biomarkers and ferritin were still elevated but lower compared with previous examinations. D-dimers levels were normalized in 2/3 patients. Conclusions: Subclinical myocarditis was diagnosed as an early outcome in infants with MIS diagnosed postnatally due to the vertical transmission of SARS-CoV2 infection and may represent a new challenge for pediatricians in the pandemic era. |
| first_indexed | 2024-03-08T20:27:28Z |
| format | Article |
| id | doaj.art-d8eb5b2305884a409dc7fad600e2d2f1 |
| institution | Directory Open Access Journal |
| issn | 2036-7503 |
| language | English |
| last_indexed | 2024-03-08T20:27:28Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pediatric Reports |
| spelling | doaj.art-d8eb5b2305884a409dc7fad600e2d2f12023-12-22T14:31:11ZengMDPI AGPediatric Reports2036-75032023-10-0115459159810.3390/pediatric15040054Early Outcome of Multisystem Inflammatory Syndrome in Neonates Diagnosed following Prenatal Maternal COVID-19 Infection: A Three-Case SeriesMaria Terciu0Ioana Luca1Emilia Panait2Eugene Leibovitz3Maria Mitrica4Bianca Popovici5Anca Ilea6Oana Gabriela Falup-Pecurariu7Children’s Clinical Hospital, 500002 Brasov, RomaniaChildren’s Clinical Hospital, 500002 Brasov, RomaniaChildren’s Clinical Hospital, 500002 Brasov, RomaniaFaculty of Medicine, Transilvania University, 500002 Brasov, RomaniaChildren’s Clinical Hospital, 500002 Brasov, RomaniaChildren’s Clinical Hospital, 500002 Brasov, RomaniaChildren’s Clinical Hospital, 500002 Brasov, RomaniaChildren’s Clinical Hospital, 500002 Brasov, RomaniaBackground: The aim of this case series report is to evaluate the characteristics of multisystem inflammatory syndrome (MIS) in neonates following prenatal maternal COVID-19 infection. Methods: We present a case series of three newborns (≤28 days of age) diagnosed with MIS due to the vertical transmission of SARS-CoV2 infection and admitted from 1 January 2021 to 1 June 2023. The inclusion criteria were negative RT-PCR-SARS-CoV-2 test in infants, initial negative IgM-SARS-CoV-2 in infants followed by the emergence of positive IgG-SARS-CoV-2 antibodies in infants and maternal COVID-19 infection in the third trimester of pregnancy. Patients enrolled in this case series were admitted due to acute febrile illnesses. Results: All three cases occurred in patients born at a mean gestational age of 39 weeks and who were appropriate for gestational age. The mean age at admission was 18.3 days. Fibrinogen (>400 mg/dL) and ferritin (>120 mg/dL) were elevated above the upper normal limit. Elevated levels of myocardial biomarkers (D-dimers, N-terminal pro b-type natriuretic peptide troponin T and creatine phosphokinase myocardial band) were recorded, with normal heart function evaluated using echocardiography. All three patients were treated with antibiotics; one received intravenous immunoglobulin. A 4-week follow-up was completed in two patients when their myocardial biomarkers and ferritin were still elevated but lower compared with previous examinations. D-dimers levels were normalized in 2/3 patients. Conclusions: Subclinical myocarditis was diagnosed as an early outcome in infants with MIS diagnosed postnatally due to the vertical transmission of SARS-CoV2 infection and may represent a new challenge for pediatricians in the pandemic era.https://www.mdpi.com/2036-7503/15/4/54MIS-NneonatesCOVID-19SARS-CoV-2 |
| spellingShingle | Maria Terciu Ioana Luca Emilia Panait Eugene Leibovitz Maria Mitrica Bianca Popovici Anca Ilea Oana Gabriela Falup-Pecurariu Early Outcome of Multisystem Inflammatory Syndrome in Neonates Diagnosed following Prenatal Maternal COVID-19 Infection: A Three-Case Series Pediatric Reports MIS-N neonates COVID-19 SARS-CoV-2 |
| title | Early Outcome of Multisystem Inflammatory Syndrome in Neonates Diagnosed following Prenatal Maternal COVID-19 Infection: A Three-Case Series |
| title_full | Early Outcome of Multisystem Inflammatory Syndrome in Neonates Diagnosed following Prenatal Maternal COVID-19 Infection: A Three-Case Series |
| title_fullStr | Early Outcome of Multisystem Inflammatory Syndrome in Neonates Diagnosed following Prenatal Maternal COVID-19 Infection: A Three-Case Series |
| title_full_unstemmed | Early Outcome of Multisystem Inflammatory Syndrome in Neonates Diagnosed following Prenatal Maternal COVID-19 Infection: A Three-Case Series |
| title_short | Early Outcome of Multisystem Inflammatory Syndrome in Neonates Diagnosed following Prenatal Maternal COVID-19 Infection: A Three-Case Series |
| title_sort | early outcome of multisystem inflammatory syndrome in neonates diagnosed following prenatal maternal covid 19 infection a three case series |
| topic | MIS-N neonates COVID-19 SARS-CoV-2 |
| url | https://www.mdpi.com/2036-7503/15/4/54 |
| work_keys_str_mv | AT mariaterciu earlyoutcomeofmultisysteminflammatorysyndromeinneonatesdiagnosedfollowingprenatalmaternalcovid19infectionathreecaseseries AT ioanaluca earlyoutcomeofmultisysteminflammatorysyndromeinneonatesdiagnosedfollowingprenatalmaternalcovid19infectionathreecaseseries AT emiliapanait earlyoutcomeofmultisysteminflammatorysyndromeinneonatesdiagnosedfollowingprenatalmaternalcovid19infectionathreecaseseries AT eugeneleibovitz earlyoutcomeofmultisysteminflammatorysyndromeinneonatesdiagnosedfollowingprenatalmaternalcovid19infectionathreecaseseries AT mariamitrica earlyoutcomeofmultisysteminflammatorysyndromeinneonatesdiagnosedfollowingprenatalmaternalcovid19infectionathreecaseseries AT biancapopovici earlyoutcomeofmultisysteminflammatorysyndromeinneonatesdiagnosedfollowingprenatalmaternalcovid19infectionathreecaseseries AT ancailea earlyoutcomeofmultisysteminflammatorysyndromeinneonatesdiagnosedfollowingprenatalmaternalcovid19infectionathreecaseseries AT oanagabrielafaluppecurariu earlyoutcomeofmultisysteminflammatorysyndromeinneonatesdiagnosedfollowingprenatalmaternalcovid19infectionathreecaseseries |