The youngest surviving COVID-19 patient: A case report.

Introduction and importance: Vertical transmission of the novel coronavirus, known as severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has not yet been proven. However, several case reports and case series worldwide, including ours, support this certain type of transmission. Although COVID-19 has been mostly treated supportively, in some cases, including ours, medical treatment seems to be essential. Case presentation: Herein, we present a case of a neonate born to an asymptomatic mother with no known history of COVID-19 during pregnancy who was diagnosed as an asymptomatic silent carrier following the confirmation of COVID-19 in her newborn. Although bacterial pneumonia, early-onset sepsis, and meconium aspiration syndrome were the possible differential diagnosis, positive COVID-19 real-time reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed the diagnosis. Due to the neonate's critical lung involvement leading to a critical condition, remdesivir, intravenous immune globulin (IVIG) and corticosteroid were administered. The patient fully recovered and was discharged after around 20 days. Clinical discussion: Although treatment in most cases of neonatal COVID-19 has been mainly supportive, in a few case reports remdesivir, corticosteroids and IVIG have been successfully used. Since a satisfying clinical improvement was not noticed following sepsis workup, all the three aforementioned medications were administered. Conclusion: Immunomodulatory medications as well as antiviral therapy should be considered in severe neonatal COVID-19 cases, as were shown to be lifesaving in our patient. Interestingly, to date, this case seems to be the youngest survived patient who has received medicines other than supportive care.

Comparison of Umbilical Cord Serum Vitamin D Levels between Infants with Transient Tachypnea of the Newborn and those without Respiratory Distress.

BACKGROUND: Transient tachypnea of the newborn (TTN) is one of the most frequent causes of respiratory distress in neonates. A relationship has been shown between vitamin D deficiency and respiratory disorders in neonates. This research was carried out to evaluate the serum level of vitamin D in TTN newborns and their mothers compared to the control group. METHODS: This case-control research was conducted during 2016-2019 in a general hospital affiliated with Mashhad University of Medical Sciences, Iran. Thirty-four infants with TTN and 82 neonates in the control group as well as their mothers were investigated. The levels of umbilical cord serum vitamin D in infants with TTN and also their mothers were compared to the control group. RESULTS: The mean levels of serum vitamin D in infants with TTN and their mothers were 8.11 ± 4.32 and 12.6 ± 10.12 ng/mL, respectively (P<0.001), whereas they were 19.21 ± 12.71 and 25.96 ± 16.6 ng/mL in the newborns of the control group and their mothers, respectively (P<0.001). The mean differences (95% CI) of neonatal and maternal vitamin D level between the two groups were 11.10 (7.92-14.28) and 13.36 (7.90-18.08), respectively. In the TTN group, 100% of the infants had vitamin D levels less than 30 ng/mL (79.4% had severe, 17.6% had moderate and 2.9% showed mild deficiency). However, vitamin D levels lower than 30 ng/mL were observed in 76.4% of the neonates in the control group (28.8% had severe, 31.1% showed moderate and 16.3% had a mild deficiency) (P<0.001). CONCLUSION: The serum vitamin D levels of infants with TTN and their mothers were significantly lower than the control group. Therefore, TTN in infants may be reduced through the treatment of vitamin D deficiency in mothers.

Transplanting pediatric deceased-donor kidneys into adult recipients: an Iranian experience.

OBJECTIVES: This study sought to evaluate graft outcome of kidneys from deceased-donor pediatric donors in adult recipients, and compare it with outcomes of kidney transplants from adult donors. MATERIALS AND METHODS: This historical cohort study involved 2 groups. Group 1 included 23 first kidney adult recipients who received their first renal transplant from pediatric deceased-donor donors. Group 2 consisted of 33 first renal transplant adult recipients with kidneys coming from adult deceased donors. The Kaplan-Meier method was used to generate graft survival and patient survival curves. The log-rank test was done to compare differences between survival outcomes. RESULTS: Graft survival rates at 1 and 5 years were 96% and 85% in group 1, and 91% and 85% in group 2. No significant difference existed in graft survival rates between the groups. Patient survival rates at 1 and 5 years in group 1 were 94% and 94% compared with 91% and 91% for group 2. No significant difference existed in graft survival rates between the groups. CONCLUSIONS: This study demonstrates that with our experience, improvement in surgical technique and immunosuppressive therapy, pediatric deceased-donor kidneys may be considered as an alternate option for adult recipients. Renal transplants from pediatric donors into adult recipients is associated with good graft and patient survival outcomes.