患儿男,7日龄,因新型冠状病毒核酸检测阳性半天入院。患儿40+2周剖宫产出生,其母于分娩前1 d确诊为奥密克戎变异株感染引起的新型冠状病毒肺炎(coronavirus disease 2019,COVID-19),分娩后母婴分离,患儿由父亲照顾。生后3 d患儿父亲确诊为COVID-19,患儿于生后7 d确诊。患儿确诊第2天出现高热、呼吸困难、低氧及喂养困难,胸部CT示双肺实变合并磨玻璃样改变,以背侧胸膜下为主。患儿入院后予低流量氧疗及体位管理等对症支持治疗,住院10 d后治愈出院。该例新生儿为国内首例报道的由奥密克戎变异株感染引起的新生儿重型COVID-19。当产妇或新生儿照顾者为COVID-19疑似或确诊病例时,应对新生儿采取恰当的保护措施,避免新生儿感染。
Abstract
A 7-day-old male neonate was admitted due to testing positive for SARS-CoV-2. The neonate was born through cesarian section at 40 weeks and 2 days of gestation. His mother was diagnosed with coronavirus disease 2019 (COVID-19) caused by Omicron variant infection 1 day before delivery. The neonate was separated from his mother after birth and was taken care of by his father. Three days after the neonate was born, his father was also diagnosed with COVID-19. The neonate was diagnosed with COVID-19 on day 7 of life. The neonate presented with hyperpyrexia, dyspnea, hypoxia, and feeding difficulties, and the chest CT showed the coexistence of consolidation and ground glass-like changes mainly located below the posterior pleura. He was given symptomatic support treatment such as low flow oxygen therapy and posture management after admission. He was cured and discharged after 10 days of hospitalization. This is the first reported case of neonatal severe COVID-19 caused by Omicron variant infection in China. It is necessary to take appropriate protective measures for the neonate to prevent infection when the mother or caregiver of the neonate is a suspected or confirmed cases of COVID-19.
关键词
新型冠状病毒肺炎 /
奥密克戎变异株 /
临床表现 /
新生儿
Key words
Coronavirus disease 2019 /
Omicron variant /
Clinical manifestation /
Neonate
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
1 中华人民共和国国家卫生健康委员会. 新型冠状病毒肺炎诊疗方案(试行第九版)[J]. 中华临床感染病杂志, 2022, 15(2): 81-89. DOI: 10.3760/cma.j.issn.1674-2397.2022.02.001.
2 余增渊, 薛伟, 冯迎军, 等. 新生儿重型新型冠状病毒肺炎转运治疗1例病例报告[J]. 中国循证儿科杂志, 2020, 15(1): 37-41. DOI: 10.3969/j.issn.1673-5501.2020.01.009.
3 Trevisanuto D, Cavallin F, Cavicchiolo ME, et al. Coronavirus infection in neonates: a systematic review[J]. Arch Dis Child Fetal Neonatal Ed, 2021, 106(3): 330-335. PMID: 32943533. DOI: 10.1136/archdischild-2020-319837.
4 周建国, 范巧玲, 陆春梅, 等. 新型冠状病毒肺炎儿童定点医院管理经验分享[J]. 中国当代儿科杂志, 2022, 24(8): 839-845. PMID: 36036119. PMCID: PMC9425868. DOI: 10.7499/j.issn.1008-8830.2206068.
5 时艳艳, 卢燕鸣, 闫钢风, 等. 儿童新型冠状病毒Omicron株和肺炎支原体混合感染重症肺炎1例[J]. 中华儿科杂志, 2022, 60(6): 600-602. PMID: 35582946. DOI: 10.3760/cma.j.cn112140-20220430-00400.
6 周昀, 杨根东, 冯凯, 等. 婴幼儿2019冠状病毒病的临床特点及胸部CT表现[J]. 中国当代儿科杂志, 2020, 22(3): 215-220. PMID: 32204756. PMCID: PMC7389590. DOI: 10.7499/j.issn.1008-8830.2020.03.007.
7 冯肖媛, 陶旭炜, 曾凌空, 等. 肺部超声在新生儿新型冠状病毒肺炎诊断中的应用 [J] . 中华儿科杂志, 2020, 58 (5): 347-350. PMID: 32392948. DOI: 10.3760/cma.j.cn112140-20200228-00154.
8 张澜, 杨童玲, 王瑾, 等. 上海市2022年3至5月新型冠状病毒疫情防控中复旦大学附属儿科医院新生儿人群实施气泡式管理的实践和效果[J]. 中国循证儿科杂志, 2022, 17(3): 169-174. DOI: 10.3969/j.issn.1673-5501.2022.03.002.
9 Martins-Filho PR, Santos VS, Santos HP. To breastfeed or not to breastfeed? Lack of evidence on the presence of SARS-CoV-2 in breastmilk of pregnant women with COVID-19[J]. Rev Panam Salud Publica, 2020, 44: e59. PMID: 32454808. PMCID: PMC7241574. DOI: 10.26633/RPSP.2020.59.
10 Lee CY, Lin RTP, Renia L, et al. Serological approaches for COVID-19: epidemiologic perspective on surveillance and control[J]. Front Immunol, 2020, 11: 879. PMID: 32391022. PMCID: PMC7194125. DOI: 10.3389/fimmu.2020.00879.