Fatal COVID-19 in a Child with Persistence of SARS-CoV-2 Despite Extensive Multidisciplinary Treatment: A Case Report
Critical Coronavirus disease 2019 (COVID-19) developed in a 7-year-old girl with a history of dystrophy, microcephaly, and central hypothyroidism. Starting with gastrointestinal symptoms, the patient developed severe myocarditis followed by progressive multiple organ failure complicated by <i>...
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Format: | Article |
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MDPI AG
2021-06-01
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Series: | Children |
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Online Access: | https://www.mdpi.com/2227-9067/8/7/564 |
id |
doaj-6b31ae7c9f964e25a2640dfad8a1df0a |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sofia Apostolidou Theresa Harbauer Peter Lasch Daniel Biermann Maja Hempel Marc Lütgehetmann Susanne Pfefferle Jochen Herrmann André Rüffer Konrad Reinshagen Rainer Kozlik-Feldmann Anna Gieras Inga Kniep Jun Oh Dominique Singer Chinedu Ulrich Ebenebe Robin Kobbe |
spellingShingle |
Sofia Apostolidou Theresa Harbauer Peter Lasch Daniel Biermann Maja Hempel Marc Lütgehetmann Susanne Pfefferle Jochen Herrmann André Rüffer Konrad Reinshagen Rainer Kozlik-Feldmann Anna Gieras Inga Kniep Jun Oh Dominique Singer Chinedu Ulrich Ebenebe Robin Kobbe Fatal COVID-19 in a Child with Persistence of SARS-CoV-2 Despite Extensive Multidisciplinary Treatment: A Case Report Children coronavirus disease 2019 (COVID-19) children DExH-BOX helicase 30 (DHX30) extracorporeal life support (ECLS) Impella |
author_facet |
Sofia Apostolidou Theresa Harbauer Peter Lasch Daniel Biermann Maja Hempel Marc Lütgehetmann Susanne Pfefferle Jochen Herrmann André Rüffer Konrad Reinshagen Rainer Kozlik-Feldmann Anna Gieras Inga Kniep Jun Oh Dominique Singer Chinedu Ulrich Ebenebe Robin Kobbe |
author_sort |
Sofia Apostolidou |
title |
Fatal COVID-19 in a Child with Persistence of SARS-CoV-2 Despite Extensive Multidisciplinary Treatment: A Case Report |
title_short |
Fatal COVID-19 in a Child with Persistence of SARS-CoV-2 Despite Extensive Multidisciplinary Treatment: A Case Report |
title_full |
Fatal COVID-19 in a Child with Persistence of SARS-CoV-2 Despite Extensive Multidisciplinary Treatment: A Case Report |
title_fullStr |
Fatal COVID-19 in a Child with Persistence of SARS-CoV-2 Despite Extensive Multidisciplinary Treatment: A Case Report |
title_full_unstemmed |
Fatal COVID-19 in a Child with Persistence of SARS-CoV-2 Despite Extensive Multidisciplinary Treatment: A Case Report |
title_sort |
fatal covid-19 in a child with persistence of sars-cov-2 despite extensive multidisciplinary treatment: a case report |
publisher |
MDPI AG |
series |
Children |
issn |
2227-9067 |
publishDate |
2021-06-01 |
description |
Critical Coronavirus disease 2019 (COVID-19) developed in a 7-year-old girl with a history of dystrophy, microcephaly, and central hypothyroidism. Starting with gastrointestinal symptoms, the patient developed severe myocarditis followed by progressive multiple organ failure complicated by <i>Pseudomonas aeruginosa</i> bloodstream infection. Intensive care treatment consisting of invasive ventilation, drainage of pleural effusion, and high catecholamine therapy could not prevent the progression of heart failure, leading to the implantation of venoarterial extracorporeal life support (VA-ECLS) and additional left ventricle support catheter (Impella<sup>®</sup> pump). Continuous venovenous hemofiltration (CVVH) and extracorporeal hemadsorption therapy (CytoSorb<sup>®</sup>) were initiated. Whole exome sequencing revealed a mutation of unknown significance in DExH-BOX helicase 30 (<i>DHX30</i>), a gene encoding a RNA helicase. COVID-19 specific antiviral and immunomodulatory treatment did not lead to viral clearance or control of hyperinflammation resulting in the patient’s death on extracorporeal life support-(ECLS)-day 20. This fatal case illustrates the potential severity of pediatric COVID-19 and suggests further evaluation of antiviral treatment strategies and vaccination programs for children. |
topic |
coronavirus disease 2019 (COVID-19) children DExH-BOX helicase 30 (DHX30) extracorporeal life support (ECLS) Impella |
url |
https://www.mdpi.com/2227-9067/8/7/564 |
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doaj-6b31ae7c9f964e25a2640dfad8a1df0a2021-07-23T13:35:39ZengMDPI AGChildren2227-90672021-06-01856456410.3390/children8070564Fatal COVID-19 in a Child with Persistence of SARS-CoV-2 Despite Extensive Multidisciplinary Treatment: A Case ReportSofia Apostolidou0Theresa Harbauer1Peter Lasch2Daniel Biermann3Maja Hempel4Marc Lütgehetmann5Susanne Pfefferle6Jochen Herrmann7André Rüffer8Konrad Reinshagen9Rainer Kozlik-Feldmann10Anna Gieras11Inga Kniep12Jun Oh13Dominique Singer14Chinedu Ulrich Ebenebe15Robin Kobbe16Division of Neonatology and Pediatric Critical Care Medicine, University Children’s Hospital, University Medical Center Eppendorf, 20246 Hamburg, GermanyDivision of Neonatology and Pediatric Critical Care Medicine, University Children’s Hospital, University Medical Center Eppendorf, 20246 Hamburg, GermanyPediatric Intensive Care Medicine, Department of Pediatrics, Clinic Bremen-Mitte, Bremen Hospital Group, 28205 Bremen, GermanyDepartments of Pediatric Cardiology and Pediatric Cardiac Surgery, Clinic for Children’s Heart Medicine, University Heart and Vascular Center Hamburg, 20246 Hamburg, GermanyInstitute of Human Genetics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyInstitute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyInstitute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanySection of Pediatric Radiology, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Children’s Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartments of Pediatric Cardiology and Pediatric Cardiac Surgery, Clinic for Children’s Heart Medicine, University Heart and Vascular Center Hamburg, 20246 Hamburg, GermanyDepartment of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartments of Pediatric Cardiology and Pediatric Cardiac Surgery, Clinic for Children’s Heart Medicine, University Heart and Vascular Center Hamburg, 20246 Hamburg, GermanyDepartment of Immunology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, GermanyDepartment of Pediatric Nephrology, University Children’s Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDivision of Neonatology and Pediatric Critical Care Medicine, University Children’s Hospital, University Medical Center Eppendorf, 20246 Hamburg, GermanyDivision of Neonatology and Pediatric Critical Care Medicine, University Children’s Hospital, University Medical Center Eppendorf, 20246 Hamburg, GermanyFirst Department of Medicine, Division of Infectious Diseases, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyCritical Coronavirus disease 2019 (COVID-19) developed in a 7-year-old girl with a history of dystrophy, microcephaly, and central hypothyroidism. Starting with gastrointestinal symptoms, the patient developed severe myocarditis followed by progressive multiple organ failure complicated by <i>Pseudomonas aeruginosa</i> bloodstream infection. Intensive care treatment consisting of invasive ventilation, drainage of pleural effusion, and high catecholamine therapy could not prevent the progression of heart failure, leading to the implantation of venoarterial extracorporeal life support (VA-ECLS) and additional left ventricle support catheter (Impella<sup>®</sup> pump). Continuous venovenous hemofiltration (CVVH) and extracorporeal hemadsorption therapy (CytoSorb<sup>®</sup>) were initiated. Whole exome sequencing revealed a mutation of unknown significance in DExH-BOX helicase 30 (<i>DHX30</i>), a gene encoding a RNA helicase. COVID-19 specific antiviral and immunomodulatory treatment did not lead to viral clearance or control of hyperinflammation resulting in the patient’s death on extracorporeal life support-(ECLS)-day 20. This fatal case illustrates the potential severity of pediatric COVID-19 and suggests further evaluation of antiviral treatment strategies and vaccination programs for children.https://www.mdpi.com/2227-9067/8/7/564coronavirus disease 2019 (COVID-19)childrenDExH-BOX helicase 30 (DHX30)extracorporeal life support (ECLS)Impella |