Severe Apparent Life-threatening Event (ALTE) in an Infant with SARS-CoV 2 Infection

The 2019 novel coronavirus (severe acute respiratory syndrome-coronavirus: SARS-CoV-2) has currently caused a global outbreak of infection. In general, children with the coronavirus disease-2019 have been reported to show milder respiratory symptoms as a respiratory infection than adult patients. Here, we describe SARS-CoV-2 infection in an infant who presented with a severe episode of apparent life-threatening event (ALTE). An 8-month-old otherwise healthy infant who was transported to our hospital because of a sudden cardiopulmonary arrest. Approximately one hour before this episode, she was almost fine but in a slightly worse humor than usual. On arrival at our hospital, sever acidosis but no clear sign of inflammatory response was denoted. A chest computed tomography scan showed weak consolidations in the upper right lung as well as atelectasis in the lower left lung. No sign of congenital heart disease or cardiomyopathy was observed in echocardiography, and no significant arrhythmia was observed in the later clinical course. Of note, the specific SARS-CoV-2 RNA was detected in both of her tracheal aspirate and urine sample by real-time RT-PCR. Although further accumulation of the cases is indispensable, our case suggests that SARS-CoV-2 infection may be one of the underlying factors in the pathophysiology of ALTE.