Neonatal Sepsis as a Risk Factor Associated with Severe COVID-19: A Case Report with Clinical and Imaging Features

Background: It has been believed that infants are at lower risk for the severe symptoms and complications that arise from COVID-19. This report represents details on a newborn with sepsis that has been diagnosed with COVID-19 and, unfortunately, did not survive. Case presentation: This is a one-day-old female newborn who was admitted to the surgical intensive care unit in Namazee Hospital, Shiraz, Iran for a bladder exstrophy operation. She gradually started to deteriorate on the fourth day after the surgery, diagnosed with sepsis based on the results of her blood culture. Progressively, her vital signs and blood tests fell within normal ranges after treating with broad-spectrum antibiotics. Without any fever, the neonate became severely irritable on the 16th day after the birth while hospitalization . Considering  lymphopenia, high CRP, and abnormal chest x-ray, pharyngeal swab sampled for COVID 19. The newborn died from multi-organ failure on 18 days of life. The blood culture results were negative, while reverse transcription-polymerase chain reaction (RT-PCR) confirmed the COVID 19 infection in the dead newborn. The parents’ pharyngeal sample, however, was negative for COVID 19. Conclusion: Growing awareness of sepsis as a risk factor for the severity of the COVID-19 infection in the neonatal period can be a form of knowledge for physicians to begin early treatment and reduce odds of mortality in this group of patients.