Neonatal Multisystem Inflammatory Syndrome Associated with Passive Transfer of Antibodies

Abstract

Multisystem Inflammatory Syndrome in Children (MIS-C) is a postinfection immune-mediated condition, seen four to six weeks after Coronavirus Disease-2019 (COVID-19). Multisystem Inflammatory Syndrome in Neonates (MIS-N) is a similar hyperinflammatory syndrome seen among neonates. The exact mechanism of MIS-N is not clear. The transplacental transfer of antibodies from Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infected mothers may lead to hyperinflammatory response among the neonates. In the current case report, the first 36-week-gestational-age male baby presented with respiratory symptoms and increased coronary Z scores which responded well to Intravenous Immunoglobulins (i.v. IG), steroids, and aspirin. The second 36-week-gestational-age male baby presented with unusual recurrent apnoeic attacks for that gestation (36 weeks) which responded dramatically to i.v IG and steroids. Immunoglobulins play a key role in the management of MIS-N.

Keywords

• coronavirus disease-2019
• immunoglobulins
• neonatal hyperimmune response
• transplacental transfer