key: cord-1055794-r0af6n6l
authors: Beniwal, Neetu; Chaudhary, Payal; Suman, Rameshwar Lal
title: Severe COVID-19 in an Infant with Severe Acute Malnutrition
date: 2021-08-03
journal: Indian J Pediatr
DOI: 10.1007/s12098-021-03896-1
sha: 8940b9a3071974a5b2b1a9fc77a17b0b3ff2b482
doc_id: 1055794
cord_uid: r0af6n6l

nan

The SARS-CoV-2 is responsible for severe viral pneumonia. WHO declared COVID-19 a pandemic on 11th March 2020 [1] . The pandemic is undermining nutrition across the world, particularly in low-and middle-income countries [2] .The worst consequences of this crisis is borne by children.

A 6-mo-old female infant presented with fever, diarrhea, difficulty in breathing since 5 d and was admitted in the pediatric isolation ward of a tertiary level hospital of Udaipur, Rajasthan (India). On GPE baby was febrile, had tachycardia, tachypnea with chest retraction and nasal flaring. SpO2 was 94% on room air. Baby had pallor, hyperpigmented knuckles, and thin and hypopigmented hair. Weightfor-length was < 3 SD of the median. Systemic examination revealed bilateral crepitations on auscultation. Nasopharyngeal swab of the infant for RT-PCR was positive.

On laboratory testing there was dimorphic anemia (Hb-8.7 g/dL), TLC was 4200/ dL, platelet count was normal, serum CRP was raised (88.29), D-dimer was high (8299 ng/ mL), serum ferritin was also raised (1650 ng/mL). HRCT revealed multiple patchy area of consolidation.

Treatment started immediately according to protocol of the Ministry of Health and Family Welfare of India with O 2 inhalation, IV antibiotics, IV methylprednisolone, inj. enoxaparin. Feeding initiated via NG tube. Baby improved and O 2 support was weaned off after 5 d and baby was discharged after nutritional rehabilitation.

Severe acute malnutrition predisposes children to various infections due to decrease in immune response. Malnutrition affects both the innate and adaptive immune responses [3] . Some micronutrients have important role in innate immune response. Although COVID-19 has been largely causing asymptomatic illness in children but presence of comorbidities is a risk factor for severe illness. Previous case report on a malnourished child with severe COVID-19 reported death of the child [4] . Early diagnosis and treatment will result in better management of patients and fewer mortality.

Conflict of Interest None.

In: Word Health Organisation

Covid -19 pandemic and mitigation strategies: implication for matrenal and child health and nutrition

Changes in nutritional status impact immune cell metabolism and function

Fatal Covid -19 in a malnourished child with megaloblastic anemia