Subject(s)
COVID-19 , Infant, Premature, Diseases , Apnea/diagnosis , COVID-19/diagnosis , Diagnostic Tests, Routine , Humans , Infant , Infant, Newborn , Infant, PrematureSubject(s)
COVID-19 , Pandemics , Apnea/diagnosis , Apnea/epidemiology , Brain Death/diagnosis , Humans , SARS-CoV-2ABSTRACT
INTRODUCTION: Apnea testing remains essential for the clinical evaluation of brain death determination. In patients who test positive for SARS-CoV-2, disconnecting the patient from the ventilator and introducing high flow oxygen into the endotracheal tube increases the risk for aerosolization of airway secretions and exposure of the examiner. METHODS: Case report of a patient with an intracerebral hemorrhage that evolved to significant cerebral edema and herniation, who underwent apnea test using a method involving a t-piece and an HME filter. RESULTS: Patient successfully pronounced brain dead using a safe method to minimize exposure to SARS-CoV-2. CONCLUSION: At a time where healthcare workers are at high risk of exposure to COVID-19, the above described method is a safe process for apnea testing in declaration of brain death.
Subject(s)
Apnea/diagnosis , Brain Death/diagnosis , Brain Edema/etiology , COVID-19/complications , Cerebral Hemorrhage/etiology , Encephalocele/etiology , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Occupational Health , Apnea/etiology , Brain Edema/diagnosis , COVID-19/diagnosis , COVID-19/transmission , Cerebral Hemorrhage/diagnosis , Encephalocele/diagnosis , Fatal Outcome , Humans , Male , Middle AgedABSTRACT
BACKGROUND: Data regarding coronavirus disease 2019 (COVID-19) cases and outcomes in infants are sparse compared to older pediatric and adult populations. CASE PRESENTATION: We present a three-week-old full-term male with a history of mild hypoxic ischemic encephalopathy (HIE) who was admitted as an inpatient twice for episodes of apnea and perioral cyanosis. The patient tested positive for COVID-19 and negative for other common respiratory viruses at both admissions. CONCLUSIONS: To our knowledge, this is the first report of apnea and perioral cyanosis associated with COVID-19 in an infant. This case highlights a previously undocumented COVID-19 presentation and suggests that even mildly symptomatic infants warrant viral diagnostic testing in an effort to prevent further spread of the disease.