Intrauterine onset of multisystem inflammatory syndrome in a neonate temporally associated with maternal COVID-19

ABSTRACT

Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 is a rare but often life-threatening clinical entity that presents 3-6 weeks after SARS-CoV-2 infection with high fever, organ dysfunction, and strongly elevated markers of inflammation. Unlike MIS-C, where SARS-CoV-2 infection and multisystem inflammation occur in the same subject, maternal SARS-CoV-2 infection may cause a similar hyperinflammatory syndrome in neonates called multisystem inflammatory syndrome in neonates (MIS-N) due to transplacental transfer of antibodies. The clinical profile of these babies remains obscure due to a lack of published literature. Our case highlights the need for practicing pediatricians to be vigilant and to have a high index of clinical suspicion of MIS-N in all critically ill neonates irrespective of antenatal COVID-19 status of mother.